A myriad of pathways to NASH.

Mary E Rinella, Soledad Larrain

Journal: Clinics in liver disease 2012;16(3):525-48

PMID: 22824479

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Abstract

Nonalcoholic steatohepatitis (NASH) is defined histopathologically by the presence of macrovesicular steatosis, cellular ballooning, and inflammation. NASH represents a complex multifactorial disease that typically occurs within the context of the metabolic syndrome. NASH lacks homogeneity, and other forms of NASH can present atypically. Less than 50% of patients with NASH respond to pharmacologic treatment, which speaks to this heterogeneity. The authors discuss drugs, disease entities, and nutritional states that can cause or exacerbate underlying NASH indirectly through worsening insulin resistance or directly by interfering with lipid metabolism, promoting oxidative injury, or activating inflammatory pathways.

Address: Division of Gastroenterology & Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

DOI: 10.1016/j.cld.2012.05.009

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MeSH Terms: Amiodarone, Anti-Retroviral Agents, Bacterial Infections, Cannabis, Diet, Fatty Liver, Genetic Diseases, Inborn, Glucocorticoids, Humans, Hypothyroidism, Insulin Resistance, Intestinal Diseases, Lipid Metabolism, Metabolic Syndrome, Methotrexate, Non-alcoholic Fatty Liver Disease, Occupational Diseases, Perhexiline