Emerging concepts on pathogenesis of NASH
(2013) Non-Alcoholic Fatty Liver Disease: A Practical Guide — ISBN: [978-0-470-67317-1], published
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- Abstract
- Key Points • NAFLD and NASH are associated with obesity and insulin resistance, and they are the hepatic consequence of the metabolic syndrome. • The fatty and insulin-resistant liver contributes importantly to hyperglycemia and thus to the evolution toward type 2 diabetes, as well as to cardiovascular risk factors. • Fatty liver results from an imbalance between lipid acquisition and removal. • Insulin resistance, altered innate immunity, metabolic dysfunction, and adipose tissue inflammation are prominent pathogenic factors in the metabolic syndrome and NAFLD. • NAFLD and NASH share many pathogenic processes: insulin resistance, chronic oxidative stress, altered lipid metabolism and lipid partitioning, chronic inflammation including chronic activation of intracellular pro-inflammatory pathways and altered adipokine profile, and altered innate immunity. • The pathogenic factors that contribute specifically to progression from steatosis to NASH remain poorly understood, so that identification of at-risk patients for NASH remains difficult. • From the above two considerations, it is hypothesized that the operation of effective or inadequate defenses to the pathogenic process is what will determine whether liver pathology is “inert” liver steatosis or progressive steatohepatitis (NASH). • Genetic factors may contribute to disease progression by determining the intensity of pathogenic stimuli and/or the efficiency of defense mechanisms.
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Citations
Leclercq, I. (2013). Emerging concepts on pathogenesis of NASH. In Geoffrey C. Farrell, Arthur J. McCullough, Christopher P. Day (ed.), Non-Alcoholic Fatty Liver Disease: A Practical Guide. Wiley-Blackwell. https://hdl.handle.net/2078.5/61951