Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Colletti, Alessandro; Mancini, John; Marais, David; Acosta, Julio; Al‐Khnifsawi, Mutaz; Alnouri, Fahad; Amar, Fahma; Atanasov, A; Bajraktari, Gani; Banach, Maciej; Bhaskar, Sonu; Bielecka‐Dąbrowa, Agata; Bjelaković, Bojko; Bruckert, Éric; Bytyçi, Ibadete; Cafferata, Alberto; Češka, Richard; Cicero, Arrigo Francesco Giuseppe; Chlebus, Krzysztof; Collet, Xavier; Daccord, Magdalena; Descamps, Olivier; Djurić, Dragan; Durst, Ronen; Ezhov, M.; Fras, Zlatko; Gaiță, Dan; Gouni‐Berthold, Ioanna; Hernández, Adrian V.; Jones, Steven R.; Jóźwiak, Jacek Jerzy; Kakauridze, N.; Kallel, Amani; Katsiki, Niki; Khera, Amit; Kostner, Karam; Kubilius, Raimondas; Latkovskis, Gustavs; Mancini, G.B. John; Ad, Marais; Martin, Seth S.; Martinez, J A; Mazidi, Mohsen; Mikhailidis, Dimitri P.; Mirrakhimov, Erkin M; Miserez, André R.; Mitchenko, O.; Mitkovskaya, Natalya P.; Moriarty, Patrick M.; Nabavi, Seyed Mohammad; Nair, Devaki; Panagiotakos, Demosthenes B.; Paragh, György; Pella, Daniel; Penson, Peter E.; Petrulionienė, Ž.; Pirro, Matteo; Postadzhiyan, Arman; Puri, Raman; Reda, Ashraf; Reiner, Željko; Radenković, Dina; Rakowski, Michał; Riadh, Jemaa; Richter, Dimitri; Rizzo, Manfredi; Ruscica, Massimiliano; Sahebkar, Amirhossein; Șerban, Maria-Corina; Shehab, Abdullah; Shek, Aleksandr B.; Sirtori, Cesare R.; Stefanutti, Claudia; Tomasik, Tomasz; Tóth, Peter P.; Viigimaa, Margus; Valdivielso, Pedro; Vinereanu, Dragoş; Vohnout, Branislav; Haehling, Stephan von; Vráblík, Michal; Wong, Nathan D.; Yeh, Hung‐I; Zhisheng, Jiang; Zirlik, Andreas

doi:10.1016/j.phrs.2023.106679

Cited by 26 publications

(21 citation statements)

References 283 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The evidence currently available regarding the use of nutraceuticals suggests hepatoprotective effects and positive outcomes on the metabolic front ( 33–53 , 82 , 83 ). Further studies are required to confirm observations and optimize nutraceutical treatment for MAFLD and to ensure their long-term efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

“…The use of nutraceuticals for the management of NAFLD is a proposition that should not be underestimated. Nutraceuticals alone or in combination with diet and lifestyle modifications promoting weight loss and reducing insulin resistance ( 33 ). The use of nutraceuticals in terms of therapeutic intervention in the presence of NAFLD is evidence-based.…”

Section: Current Treatment Of Mafldmentioning

confidence: 99%

“…Silymarin, polyunsaturated fatty acids of the ω-3 series, coenzyme Q10, berberine and curcumin possess hepatoprotective activity and exert a favorable action on the CV system. Traditional Chinese herbal combinations such as Artemisia capillaris (Thunb), Gardenia jasminoides (Ellis), and Rheum palmatum (L) exert anti-NAFLD effects ( 33 ).…”

Section: Current Treatment Of Mafldmentioning

confidence: 99%

See 2 more Smart Citations

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

Al Hashmi,

Giglio,

Pantea Stoian

et al. 2024

Front. Nutr.

Self Cite

View full text Add to dashboard Cite

The definition of “Metabolic Associated Fatty Liver Disease – MAFLD” has replaced the previous definition of Nonalcoholic Fatty Liver Disease (NAFLD), because cardiometabolic criteria have been added for the prevention of cardiological risk in these patients. This definition leads to an in-depth study of the bidirectional relationships between hepatic steatosis, Type 2 Diabetes Mellitus (T2DM), Cardiovascular Disease (CVD) and/or their complications. Lifestyle modification, which includes correct nutrition combined with regular physical activity, represents the therapeutic cornerstone of MAFLD. When therapy is required, there is not clear accord on how to proceed in an optimal way with nutraceutical or pharmacological therapy. Numerous studies have attempted to identify nutraceuticals with a significant benefit on metabolic alterations and which contribute to the improvement of hepatic steatosis. Several evidences are supporting the use of silymarin, berberine, curcumin, Nigella sativa, Ascophyllum nodosum, and Fucus vesiculosus, vitamin E, coenzyme Q10 and Omega-3. However, more evidence regarding the long-term efficacy and safety of these compounds are required. There is numerous evidence that highlights the use of therapies such as incretins or the use of Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors or other similar therapies which, by assisting existing therapies for pathologies such as diabetes, hypertension, insulin resistance, have given a breakthrough in prevention and the reduction of cardiometabolic risk. This review gave an overview of the current therapeutic strategies that are expected to aid in the treatment and prevention of MAFLD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Current Treatment Of Mafldmentioning

confidence: 99%

Section: Current Treatment Of Mafldmentioning

confidence: 99%

See 1 more Smart Citation

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

Al Hashmi,

Giglio,

Pantea Stoian

et al. 2024

Front. Nutr.

Self Cite

View full text Add to dashboard Cite

show abstract

“…A study by Rizzo et al. ( 2023 ) investigated the antioxidant capacity of silymarin in a murine model of NAFLD. The findings suggested that silymarin supplementation significantly reduced oxidative stress markers and inflammatory cytokine levels, supporting its potential as an adjunct therapy for NAFLD.…”

Section: Recent Studies On the Efficacy Of Silymarinmentioning

confidence: 99%

Silymarin: Unveiling its pharmacological spectrum and therapeutic potential in liver diseases—A comprehensive narrative review

Jaffar,

Al‐Asmari,

Khan

et al. 2024

Food Science & Nutrition

View full text Add to dashboard Cite

Liver diseases, encompassing conditions such as cirrhosis, present a substantial global health challenge with diverse etiologies, including viral infections, alcohol consumption, and non‐alcoholic fatty liver disease (NAFLD). The exploration of natural compounds as therapeutic agents has gained traction, notably the herbal remedy milk thistle (Silybum marianum), with its active extract, silymarin, demonstrating remarkable antioxidant and hepatoprotective properties in extensive preclinical investigations. It can protect healthy liver cells or those that have not yet sustained permanent damage by reducing oxidative stress and mitigating cytotoxicity. Silymarin, a natural compound with antioxidant properties, anti‐inflammatory effects, and antifibrotic activity, has shown potential in treating liver damage caused by alcohol, NAFLD, drug‐induced toxicity, and viral hepatitis. Legalon® is a top‐rated medication with excellent oral bioavailability, effective absorption, and therapeutic effectiveness. Its active component, silymarin, has antioxidant and hepatoprotective properties, Eurosil 85® also, a commercial product, has lipophilic properties enhanced by special formulation processes. Silymarin, during clinical trials, shows potential improvements in liver function, reduced mortality rates, and alleviation of symptoms across various liver disorders, with safety assessments showing low adverse effects. Overall, silymarin emerges as a promising natural compound with multifaceted hepatoprotective properties and therapeutic potential in liver diseases.

show abstract

“…Various molecular mechanisms, such as FAs uptake, transport, output, DNL, and fat acid oxidation, are utilized by the liver to regulate FAs metabolism. Altering the equilibrium of these pathways leads to the accumulation of lipids in the liver, resulting in organelle malfunction, cellular injury, apoptosis, inflammation, and persistent activation of fibrosis pathways, all of which exacerbate liver function and advance the development of MASLD ( 12 , 25 , 26 ) (as shown in Figure 2 ).…”

Section: The Disturbance Of Lipid Metabolism In Masldmentioning

confidence: 99%

Unmasking the enigma of lipid metabolism in metabolic dysfunction-associated steatotic liver disease: from mechanism to the clinic

Rao,

Peng,

et al. 2023

Front. Med.

View full text Add to dashboard Cite

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly defined as non-alcoholic fatty liver disease (NAFLD), is a disorder marked by the excessive deposition of lipids in the liver, giving rise to a spectrum of liver pathologies encompassing steatohepatitis, fibrosis/cirrhosis, and hepatocellular carcinoma. Despite the alarming increase in its prevalence, the US Food and Drug Administration has yet to approve effective pharmacological therapeutics for clinical use. MASLD is characterized by the accretion of lipids within the hepatic system, arising from a disarray in lipid provision (whether through the absorption of circulating lipids or de novo lipogenesis) and lipid elimination (via free fatty acid oxidation or the secretion of triglyceride-rich lipoproteins). This disarray leads to the accumulation of lipotoxic substances, cellular pressure, damage, and fibrosis. Indeed, the regulation of the lipid metabolism pathway is intricate and multifaceted, involving a myriad of factors, such as membrane transport proteins, metabolic enzymes, and transcription factors. Here, we will review the existing literature on the key process of lipid metabolism in MASLD to understand the latest progress in this molecular mechanism. Notably, de novo lipogenesis and the roles of its two main transcription factors and other key metabolic enzymes are highlighted. Furthermore, we will delve into the realm of drug research, examining the recent progress made in understanding lipid metabolism in MASLD. Additionally, we will outline prospective avenues for future drug research on MASLD based on our unique perspectives.

show abstract

Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Cited by 26 publications

References 283 publications

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

Silymarin: Unveiling its pharmacological spectrum and therapeutic potential in liver diseases—A comprehensive narrative review

Unmasking the enigma of lipid metabolism in metabolic dysfunction-associated steatotic liver disease: from mechanism to the clinic

Contact Info

Product

Resources

About