Present and future therapeutic strategies in non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD) is found in individuals who do not drink or abuse alcohol and represents a significant health burden for the general community. NAFLD is often associated with one or more features of the metabolic syndrome and has potential for evolution towards non-alcoholic steatohepatitis (NASH), the necro-inflammatory form of liver steatosis. The most worrisome evolutive events in a subgroup of NASH patients include advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma. Pathophysiology of NAFLD/NASH is complex, but studies point to a pre-eminent role of oxidative stress and lipid peroxidation in the liver, including early mitochondrial dysfunction. Changes follow an insulin resistance status with a background of a chronic pro-inflammatory status due to an excess of visceral adiposity. Although no established therapy exists for NAFLD/NASH, potential therapeutic approaches are discussed in this review.
Calamita
Giuseppe
G
Department of General and Environmental Physiology, University of Bari, Italy.
Portincasa
Piero
P
D000818:Animals; D005234:Fatty Liver / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D023281:Genomics; D005838:Genotype; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy