Does vitamin E improve the outcomes of pediatric nonalcoholic fatty liver disease? A systematic review and meta-analysis

Sarkhy, Ahmed Al; Al–Hussaini, Abdulrahman; Nobili, Valério

doi:10.4103/1319-3767.132983

Cited by 33 publications

(28 citation statements)

References 25 publications

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“…However, the efficacy of vitamin E in NAFLD remains to be confirmed in independent studies . In this regard, a meta‐analysis of clinical trials did not provide clear‐cut evidence for a beneficial effect of vitamin E in normalizing serum ALT in patients with NAFLD . Likewise, vitamin E was also ineffective in improving serum ALT levels and NAFLD in pediatric NAFLD .…”

Section: Antioxidants Therapy: Critical Mitochondrial Antioxidants Bamentioning

confidence: 97%

Mitochondrial Oxidative Stress and Antioxidants Balance in Fatty Liver Disease

2018

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Fatty liver disease is one of the most prevalent forms of chronic liver disease that encompasses both alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD). Alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH) are intermediate stages of ALD and NAFLD, which can progress to more advanced forms, including cirrhosis and hepatocellular carcinoma. Oxidative stress and particularly alterations in mitochondrial function are thought to play a significant role in both ASH and NASH and recognized to contribute to the generation of reactive oxygen species (ROS), as documented in experimental models. Despite the evidence of ROS generation, the therapeutic efficacy of treatment with antioxidants in patients with fatty liver disease has yielded poor results. Although oxidative stress is considered to be the disequilibrium between ROS and antioxidants, there is evidence that a subtle balance among antioxidants, particularly in mitochondria, is necessary to avoid the generation of ROS and hence oxidative stress. Conclusion: As mitochondria are a major source of ROS, the present review summarizes the role of mitochondrial oxidative stress in ASH and NASH and presents emerging data indicating the need to preserve mitochondrial antioxidant balance as a potential approach for the treatment of human fatty liver disease, which may pave the way for the design of future trials to test the therapeutic role of antioxidants in fatty liver disease.

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Section: Antioxidants Therapy: Critical Mitochondrial Antioxidants Bamentioning

confidence: 97%

Mitochondrial Oxidative Stress and Antioxidants Balance in Fatty Liver Disease

2018

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“…10 There are no licensed or uniformly recommended pharmacological therapies and bariatric surgery is only recommended if there are additional comorbidities. 11 The conclusions of other systematic reviews in the field have been limited to specific treatment modalities [12][13][14] or pharmacological options, [15][16][17] or have not distinguished children from adults. 18 One of the biggest challenges in designing a robust randomized controlled trial (RCT) in pediatric NAFLD is the lack of societal consensus on appropriate primary outcome measures.…”

mentioning

confidence: 99%

Evaluations of Lifestyle, Dietary, and Pharmacologic Treatments for Pediatric Nonalcoholic Fatty Liver Disease: A Systematic Review

Mann

Tang

Nobili

et al. 2019

Clinical Gastroenterology and Hepatology

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In a systematic review of published and active randomized controlled trials of children with NAFLD, we found a large amount of heterogeneity in study endpoints and inclusion criteria. Few trials included histologic analyses. Antioxidants appear to reduce some features of steatohepatitis. Effects of treatment with lifestyle modification, PUFAs, or probiotics have not been validated with histologic analysis. Trials that are underway quantify steatosis magnetic resonance imaging-outcomes are anticipated.

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“…However, there are contradictory reports on its effectiveness . Sarkhy et al could not find any beneficial effect of vitamin E in normalizing serum ALT in a meta‐analysis. Further, the children with NAFLD did not improve by vitamin E therapy .…”

Section: Mitochondria‐targeted Agentsmentioning

confidence: 99%

Role of mitochondria and mitochondria‐targeted agents in non‐alcoholic fatty liver disease

Ajith

2017

Clin Exp Pharma Physio

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Summary Mitochondria play a pivotal role in the fatty acid oxidation and have been found to be affected early during the macrovesicular fat accumulation in the hepatocytes. The fatty infiltration is the primary cause of oxidative stress and inflammation in the non‐alcoholic fatty liver disease (NAFLD), which can lead to the peroxidation of phospholipids, such as cardiolipin. Oxidative stress‐induced damage to mitochondrial DNA can result in the impairment of oxidative phosphorylation and further increases the generation of reactive oxygen species. The mitochondrial damage may eventually lead to apoptotic death of hepatocytes. The apoptosis along with the generated cytokines from the stellate and Kupffer cells further augment the fibrotic changes to advance the disease. Hence, alleviation of the mitochondrial impairment, particularly in the early stages of NAFLD, may prevent the progression of the disease. Among the various experimentally studied mitochondrial‐targeted agents, triphenylphosphonium cation ligated ubiquinone Q10 and vitamin E, Szeto‐Scheller peptides, and superoxide dismutase mimetic‐salen manganese complexes (EUK‐8 and EUK‐134) have been found to be most promising. In addition to these mitochondrial‐targeted agents, a novel area of therapy called mitotherapy have also emerged. However, clinical studies conducted so far are still fragmentary to validate their efficacy. This review article discusses the mitochondria‐targeted molecules and their potential role in the treatment of NAFLD.

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Does vitamin E improve the outcomes of pediatric nonalcoholic fatty liver disease? A systematic review and meta-analysis

Cited by 33 publications

References 25 publications

Mitochondrial Oxidative Stress and Antioxidants Balance in Fatty Liver Disease

Mitochondrial Oxidative Stress and Antioxidants Balance in Fatty Liver Disease

Evaluations of Lifestyle, Dietary, and Pharmacologic Treatments for Pediatric Nonalcoholic Fatty Liver Disease: A Systematic Review

Role of mitochondria and mitochondria‐targeted agents in non‐alcoholic fatty liver disease

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