Cited by 573Liver Disease Diagnosis and TreatmentLiver physiology and pathologyAlcohol Consumption and Health Effects

Recent insights into the pathogenesis of nonalcoholic fatty liver disease

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Arab, Juan Pablo, Arrese, Marco, Trauner, Michael·2018·Annual Review of Pathology Mechanisms of Disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a burgeoning health problem worldwide and an important risk factor for both hepatic and cardiometabolic mortality. The rapidly increasing prevalence of this disease and of its aggressive form nonalcoholic steatohepatitis (NASH) will require novel therapeutic approaches based on a profound understanding of its pathogenesis to halt disease progression to advanced fibrosis or cirrhosis and cancer. The pathogenesis of NAFLD involves a complex interaction among environmental factors (i.e., Western diet), obesity, changes in microbiota, and predisposing genetic variants resulting in a disturbed lipid homeostasis and an excessive accumulation of triglycerides and other lipid species in hepatocytes. Insulin resistance is a central mechanism that leads to lipotoxicity, endoplasmic reticulum stress, disturbed autophagy, and, ultimately, hepatocyte injury and death that triggers hepatic inflammation, hepatic stellate cell activation, and progressive fibrogenesis, thus driving disease progression. In the present review, we summarize the currently available data on the pathogenesis of NAFLD, emphasizing the most recent advances. A better understanding of NAFLD/NASH pathogenesis is crucial for the design of new and efficient therapeutic interventions.

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  • Bile acids have emerged as important pathogenetic factors and therapeutic targets in both cholestatic and metabolic liver diseases.

    “BAs have emerged as important pathogenetic factors and therapeutic targets in both cholestatic and metabolic liver diseases.4 13 41”

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Authors
Arab, J. P., Arrese, M., & Trauner, M.
Affiliations
  • Mayo Clinic (US)
  • Pontificia Universidad Católica de Chile (CL)
  • Medical University of Vienna (AT)
Corresponding author
Trauner, Michael
Venue
Annual Review of Pathology Mechanisms of Disease
Published
2018-01-24
Volume
13
Issue
1
Pages
321-350
ISSN
  • 1553-4006 (ISSN-L)
  • 1553-4014
OpenAlex
W2785779482
Cited by
573
References
218
Citations by year
2026: 43 · 2025: 64 · 2024: 76 · 2023: 85 · 2022: 61 · 2021: 93 · 2020: 77 · 2019: 47 · 2018: 26 · 2017: 1
FWCI
8.70
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Pathology Mechanisms of Disease (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Association for the Study of Liver Diseases
  • Vienna Science and Technology Fund
  • Austrian Science Fund (F3008‐B19, F3517-B20, F3008, F3517)
  • Fondo Nacional de Ciencia y Tecnología
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver physiology and pathology
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, pathogenesis, insulin resistance, lipotoxicity, endoplasmic reticulum stress, autophagy, liver inflammation, hepatic stellate cell activation, liver fibrosis, liver cirrhosis, hepatic lipid accumulation, gut microbiota, obesity, Western diet, genetic variants, cardiometabolic risk
MeSH terms
Animals, Humans, Non-alcoholic Fatty Liver Disease

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