Immune cell balance as potential biomarker of progressing non-alcoholic fatty liver disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a widespread chronic, slowly progressive metabolic multifactorial disease. It is represented by a number of clinical and morphological forms: steatosis, non-alcoholic steatohepatitis (NASH) (with or without fibrosis) and liver cirrhosis. The search for minimally invasive and cost-effective biomarkers of NAFLD is a key task in the diagnosis, staging of progression, and long-term monitoring of NAFLD. The article discusses the possibility of using the balance of immune cells as potential minimally invasive peripheral markers of NAFLD progression. In the progression of NASH (from steatosis to fibrosis and cirrhosis) an important role is played by inflammation realized due to the activation Kupffer cells, and increased migration of monocytes, dendritic cells, neutrophils, activated T-lymphocytes into the tissues of the organ. Macrophages originating from monocytes, with the progression of NASH, gradually begin to prevail over the pool of resident macrophages. The risk of developing NASH and fibrosis in patients with NAFLD increases with the ratio of neutrophils/lymphocytes in the liver. An increase in the number of Th17 and decrease in Treg cells can contribute to increased hepatic steatosis and the development of inflammation in NAFLD, as well as accelerate the transition from simple steatosis to steatohepatitis and fibrosis.