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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2012.1
- 수록면
- 149 - 171 (23page)
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While non-alcoholic fatty liver disease (NAFLD) is highly prevalent (15% to 45%) in modern societies, only 10% to 25% of cases develop hepatic fibrosis leading to cirrhosis,end-stage liver disease or hepatocellular carcinoma. Apart from pre-existing fibrosis, the strongest predictor of fibrotic progression in NAFLD is steatohepatitis or non-alcoholic steatohepatitis (NASH). The critical features other than steatosis are hepatocellular degeneration (ballooning, Mallory hyaline)and mixed infl ammatory cell infi ltration. While much is understood about the relationship of steatosis to metabolic factors (over-nutrition, insulin resistance, hyperglycemia, metabolic syndrome, hypoadiponectinemia), less is known about infl ammatory recruitment, despite its importance for the perpetuation of liver injury and fi brogenesis. In this review, we present evidence that liver infl ammation has prognostic signifi cance in NAFLD. We then consider the origins and components of liver infl ammation in NASH. Hepatocytes injured by toxic lipid molecules (lipotoxicity) play a central role in the recruitment of innate immunity involving Toll-like receptors (TLRs), Kupffer cells (KCs), lymphocytes and neutrophils and possibly infl ammasome. The key pro-infl ammatory signaling pathways in NASH are nuclear factor-kappa B (NF-κB) and c-Jun N-terminal kinase (JNK). The downstream effectors include adhesion molecules, chemokines, cytokines and the activation of cell death pathways leading to apoptosis. The upstream activators of NF-κB and JNK are more contentious and may depend on the experimental model used. TLRs are strong contenders. It remains possible that infl ammation in NASH originates outside the liver and in the gut microbiota that prime KC/TLR responses, infl amed adipose tissue and circulating infl ammatory cells. We briefl y review these mechanistic considerations and project their implications for the effective treatment of NASH.
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참고문헌 (23)
참고문헌 신청
Amarapurkar DN / 2007 / How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences? / J Gastroenterol Hepatol 22 : 788 ~ 793
Chitturi S / 2007 / Non-alcoholic fatty liver disease in the Asia-Pacific region: definitions and overview of proposed guidelines / J Gastroenterol Hepatol 22 : 778 ~ 787
Chitturi S / 2009 / Clues from the carotids: an appraisal of cardiovascular disease risk in non-alcoholic fatty liver disease / J Gastroenterol Hepatol 24 : 1315 ~ 1317
Chitturi S / 2011 / Nonalcoholic fatty liver in Asia: firmly entrenched and rapidly gaining ground / J Gastroenterol Hepatol 26 (Suppl 1) : 163 ~ 172
Ekstedt M / 2006 / Long-term followup of patients with NAFLD and elevated liver enzymes / Hepatology 44 : 865 ~ 873
Chitturi S / 2007 / Non-alcoholic fatty liver disease in the Asia-Pacific region: definitions and overview of proposed guidelines / J Gastroenterol Hepatol 22 : 778 ~ 787
Chitturi S / 2009 / Clues from the carotids: an appraisal of cardiovascular disease risk in non-alcoholic fatty liver disease / J Gastroenterol Hepatol 24 : 1315 ~ 1317
Chitturi S / 2011 / Nonalcoholic fatty liver in Asia: firmly entrenched and rapidly gaining ground / J Gastroenterol Hepatol 26 (Suppl 1) : 163 ~ 172
Ekstedt M / 2006 / Long-term followup of patients with NAFLD and elevated liver enzymes / Hepatology 44 : 865 ~ 873
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