Treatment of Fatty Liver Disease: The Present and the Future.

Sruthi Priyavadhana Ramanan,Pousette Hamid,Su Sandi Aung,Mohamed Wael F Mohamed,Ibrahim Sange

doi:10.7759/cureus.12713

Abstract

Non-alcoholic fatty liver disease (NAFLD) progressing to non-alcoholic steatohepatitis (NASH), cirrhosis, end-stage liver disease (ESRD), and hepatocellular carcinoma (HCC) is emerging as a global epidemic. Obesity, diabetes, and metabolic syndrome are some of the leading risk factors for NAFLD. The most prevalent treatment to stop the progression is aimed at dietary modification and lifestyle changes. Bariatric surgery is indicated for patients with morbid obesity with NAFLD. The progression of NAFLD to NASH and HCC can be arrested at various stages of pathogenesis by the already prevalent drugs and the emerging newer molecular and genetic targets. This review article analyzed various preclinical animal trials and clinical trials and has summarized various groups of drugs that can be life-altering in patients diagnosed with NAFLD. This study also discusses the obstacles in taking these clinical trials to bedside treatment.

Highlights

BackgroundNon-alcoholic fatty liver disease (NAFLD) is an emerging global epidemic with a prevalence of 25% worldwide [1]
NAFLD consists of varying liver pathology ranging from simple steatosis to ballooning degeneration, inflammation, and fibrosis which are collectively termed as non-alcoholic steatohepatitis (NASH) [2]
Unc-51 like autophagy activating kinase 1 (ULK1): Pathogenesis of NASH can be explained by a two-hit hypothesis where the first hit is due to the accumulation of triglycerides within the hepatocytes which lead to steatosis

Summary

Introduction

BackgroundNon-alcoholic fatty liver disease (NAFLD) is an emerging global epidemic with a prevalence of 25% worldwide [1]. NAFLD consists of varying liver pathology ranging from simple steatosis to ballooning degeneration, inflammation, and fibrosis which are collectively termed as non-alcoholic steatohepatitis (NASH) [2]. NASH has a propensity to progress to liver cirrhosis leading to end-stage liver disease (ESRD) and hepatocellular carcinoma (HCC). This in turn leads to an increase in the rate of a liver transplant due to non-alcoholic liver disease. NASH is frequently associated with type 2 diabetes, obesity, dyslipidemia, alterations in waist-hip ratio, and insulin resistance [4]. It is often called the hepatic manifestation of metabolic syndrome (MS)

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