Abstract
Nonalcoholic fatty liver disease (NAFLD) is a continuum of liver abnormalities often starting as simple steatosis and to potentially progress into nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis and hepatocellular carcinoma. Because of its increasing prevalence, NAFLD is becoming a major public health concern, in parallel with a worldwide increase in the recurrence rate of diabetes and metabolic syndrome. It has been estimated that NASH cirrhosis may surpass viral hepatitis C and become the leading indication for liver transplantation in the next decades. The broadening of the knowledge about NASH pathogenesis and progression is of pivotal importance for the discovery of new targeted and more effective therapies; aim of this review is to offer a comprehensive and updated overview on NAFLD and NASH pathogenesis, the most recommended treatments, drugs under development and new drug targets. The most relevant in vitro and in vivo models of NAFLD and NASH will be also reviewed, as well as the main molecular pathways involved in NAFLD and NASH development.
Highlights
In the last decades, a rise in the diffusion of chronic liver pathologies has been observed; among them, one of the most insidious is nonalcoholic fatty liver disease (NAFLD) [1]
NAFLD is characterized by the intracellular deposition of lipids in hepatocytes, often associated with a wide spectrum of metabolic abnormalities, such as dyslipidemia, hypertension, insulin resistance and diabetes; these features are collectively known as the manifestation of metabolic syndrome [2]
ADMA is a physiological compound naturally produced during protein methylation; it acts as an unspecific, competitive inhibitor of nitric oxide synthases (NOS), and its levels are often seen to be increased in patients suffering from liver disorders [43], including NAFLD and non-alcoholic steatohepatitis (NASH) [44]
Summary
A rise in the diffusion of chronic liver pathologies has been observed; among them, one of the most insidious is nonalcoholic fatty liver disease (NAFLD) [1]. The use of the term “non” has been judged to diminish the importance of the condition; on the other hand, “non-alcoholic fatty liver disease” fits the definition of “non-communicable diseases” estimated to cause >70% of global death [6]. In this context, a panel of experts recommended renaming NAFLD into metabolic (dysfunction)-associated fatty liver disease (MAFLD) [7], concomitantly with the adoption of new diagnostic criteria [8]. The most relevant in vitro and in vivo models of NAFLD and NASH will be reviewed, as well as the main molecular pathways involved in NAFLD and NASH development
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