Inflammation in Nonalcoholic Steatohepatitis

R Christopher Harmon; Dina G Tiniakos; Curtis K Argo


Expert Rev Gastroenterol Hepatol. 2011;5(2):189-200. 

In This Article

Expert Commentary

Nonalcoholic fatty liver disease is the most common chronic liver disease in the USA and worldwide. NAFLD is considered by many as the hepatic manifestation of the metabolic syndrome, currently conceptualized as a state of chronic low-grade inflammation. NASH is the progressive form of NAFLD and may advance to fibrosis and cirrhosis. Recent evidence suggests that hepatic inflammation is the driving force behind NASH, and thus is potentially a major therapeutic target. Proinflammatory mediators secreted by visceral adipose tissue, gut-derived byproducts, ER stress, and innate immunity all play key roles in the development of NASH. Currently, NASH is only accurately diagnosed via liver biopsy. In addition to acinar inflammation, portal inflammation may also play an important role in NAFLD progression. Noninvasive methods for assessing necroinflammation and fibrosis in NAFLD are emerging, but they are not currently validated for application in routine practice or for screening purposes.


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