Current management of NAFLD/NASH

Cardoso, Ana Carolina; Figueiredo-Mendes, C.; Villela-Nogueira, Cristiane Alves; Valenti, L.

doi:10.1111/liv.14869

Cited by 18 publications

(19 citation statements)

References 30 publications

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“…In agreement, vitamin E (vitE) supplementation has been shown to improve NASH histology in experimental animal models [ 6 , 7 , 8 ] and in humans [ 9 ], including large clinical trials (PIVENS (placebo vs. 800IU vitE or 30 mg Pioglitazone) [ 10 ] and TONIC (placebo vs. 800IU vitE or 1000 mg Metformin) [ 11 ]). Though mechanisms are not completely disclosed, vitE has been included as part of the treatment guidelines for some NAFLD patients [ 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Vitamin C Deficiency May Delay Diet-Induced NASH Regression in the Guinea Pig

et al. 2021

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Oxidative stress is directly linked to non-alcoholic fatty liver disease (NAFLD) and the progression to steaotohepatitis (NASH). Thus, a beneficial role of antioxidants in delaying disease progression and/or accelerating recovery may be expected, as corroborated by recommendations of, e.g., vitamin E supplementation to patients. This study investigated the effect of vitamin C deficiency—often resulting from poor diets low in fruits and vegetables and high in fat—combined with/without a change to a low fat diet on NAFLD/NASH phenotype and hepatic transcriptome in the guinea pig NASH model. Vitamin C deficiency per se did not accelerate disease induction. However, the results showed an effect of the diet change on the resolution of hepatic histopathological hallmarks (steatosis, inflammation, and ballooning) (p < 0.05 or less) and indicated a positive effect of a high vitamin C intake when combined with a low fat diet. Our data show that a diet change is important in NASH regression and suggest that a poor vitamin C status delays the reversion towards a healthy hepatic transcriptome and phenotype. In conclusion, the findings support a beneficial role of adequate vitamin C intake in the regression of NASH and may indicate that vitamin C supplementation in addition to lifestyle modifications could accelerate recovery in NASH patients with poor vitamin C status.

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Section: Introductionmentioning

confidence: 99%

Vitamin C Deficiency May Delay Diet-Induced NASH Regression in the Guinea Pig

et al. 2021

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“…296 Third, it is important to identify comorbidities in NAFLD patients in daily practice and administer immediate treatment to significantly improve the prognosis, such as bariatric surgery for obesity comorbidity and pharmaceutical therapy for diabetes comorbidity. 297 Finally, it is crucial to implement a precision-medicine-oriented approach to tailor an effective therapy for every patient individually based on their genetics, clinical features, and environmental factors. 298 To this end, it is proposed that advanced imaging techniques and various molecular tools (e.g., genetic testing, high-throughput omics, microbiome assessment) be applied to achieve a more precise and refined characterization and stratification of NAFLD and that artificial intelligence tools and high-performance computing be used to link biological information.…”

Section: Summary and Future Perspectivesmentioning

confidence: 99%

“…Second, the combined utilization of commercially available medications including natural products and western medicine has dual/multitargeted treatment effects, which augments the benefits of addressing multiple aspects of NAFLD pathogenesis . Third, it is important to identify comorbidities in NAFLD patients in daily practice and administer immediate treatment to significantly improve the prognosis, such as bariatric surgery for obesity comorbidity and pharmaceutical therapy for diabetes comorbidity . Finally, it is crucial to implement a precision-medicine-oriented approach to tailor an effective therapy for every patient individually based on their genetics, clinical features, and environmental factors .…”

Section: Summary and Future Perspectivesmentioning

confidence: 99%

Design of Hepatic Targeted Drug Delivery Systems for Natural Products: Insights into Nomenclature Revision of Nonalcoholic Fatty Liver Disease

Tang

et al. 2021

ACS Nano

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Nonalcoholic fatty liver disease (NAFLD), recently renamed metabolicdysfunction-associated fatty liver disease (MAFLD), affects a quarter of the worldwide population. Natural products have been extensively utilized in treating NAFLD because of their distinctive advantages over chemotherapeutic drugs, despite the fact that there are no approved drugs for therapy. Notably, the limitations of many natural products, such as poor water solubility, low bioavailability in vivo, low hepatic distribution, and lack of targeted effects, have severely restricted their clinical application. These issues could be resolved via hepatic targeted drug delivery systems (HTDDS) that boost clinical efficacy in treating NAFLD and decrease the adverse effects on other organs. Herein an overview of natural products comprising formulas, single medicinal plants, and their crude extracts has been presented to treat NAFLD. Also, the clinical efficacy and molecular mechanism of active monomer compounds against NAFLD are systematically discussed. The targeted delivery of natural products via HTDDS has been explored to provide a different nanotechnology-based NAFLD treatment strategy and to make suggestions for naturalproduct-based targeted nanocarrier design. Finally, the challenges and opportunities put forth by the nomenclature update of NAFLD are outlined along with insights into how to improve the NAFLD therapy and how to design more rigorous nanocarriers for the HTDDS. In brief, we summarize the up-to-date developments of the NAFLD-HTDDS based on natural products and provide viewpoints for the establishment of more stringent anti-NAFLD natural-product-targeted nanoformulations.

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“… 13 NAFLD includes a wide range of histological changes from simple fat accumulation in the liver to nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis, and even hepatocellular carcinoma (HCC). 14 With a global prevalence of 25.24%, 15 NAFLD has become one of the most common chronic liver diseases worldwide and may become a major cause of end-stage liver disease in the coming decades. As a result, NAFLD has gained the attention of physicians, experts, and health policy makers worldwide.…”

Section: Introductionmentioning

confidence: 99%