Cited by 121Liver Disease Diagnosis and TreatmentLiver physiology and pathologyDiet, Metabolism, and Disease

The DOI matches its Crossref record; 168 of the 174 references it cites were found in a registry or an index.

In Vitro and In Vivo Models of Non-Alcoholic Fatty Liver Disease: A Critical Appraisal

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Abstract

Non-alcoholic fatty liver disease (NAFLD), including non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), represents the hepatic manifestation of obesity and metabolic syndrome. Due to the spread of the obesity epidemic, NAFLD is becoming the most common chronic liver disease and one of the principal indications for liver transplantation. However, no pharmacological treatment is currently approved to prevent the outbreak of NASH, which leads to fibrosis and cirrhosis. Preclinical research is required to improve our knowledge of NAFLD physiopathology and to identify new therapeutic targets. In the present review, we summarize advances in NAFLD preclinical models from cellular models, including new bioengineered platforms, to in vivo models, with a particular focus on genetic and dietary mouse models. We aim to discuss the advantages and limits of these different models.

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Crossref · 10.3390/jcm10010036

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Figure 1 Hepatic cell sources and in vitro models of non-alcoholic fatty liver disease (NAFLD). Different cell sources are now available to build in vitro models of NAFLD. Primary human hepatocytes (PHH) display the closest phenotype to the human liver. A short culture time and low availability of PHHs are alleviated by using immortalized cell lines (HepG2, HuH7 or HepaRG) and hepatocyte-like cells (HLC) derived from stem cells (as human-induced pluripotent cell—hIPSC, embryonic stem cells—ESC or hepatic stem cells—HSC, or mesenchymal stem cells—MSC). However, altered metabolic functions and incomplete differentiation of HLC are limitations of the model. Several models have been developed to mimic NALFD in vitro. NAFLD can be studied in 2- or 3-dimensional cell cultures by adding free fat acid (FFA), Bisphenol A or Valproate in the culture medium. New 3D models have been recently developed: spheroids are derived from different hepatic cell sources; hepatic organoids are produced by stem cell differentiation in parenchymal and non-parenchymal liver cells. Livers-on-a-chip are devices designed to mimic the physiological environment of the liver lobule: hepatocytes are placed inside a micro-scaffold, and a fluidic flow passes through the chip to reproduce blood circulation.
Figure 1 Hepatic cell sources and in vitro models of non-alcoholic fatty liver disease (NAFLD). Different cell sources are now available to build in vitro models of NAFLD. Primary human hepatocytes (PHH) display the closest phenotype to the human liver. A short culture time and low availability of PHHs are alleviated by using immortalized cell lines (HepG2, HuH7 or HepaRG) and hepatocyte-like cells (HLC) derived from stem cells (as human-induced pluripotent cell—hIPSC, embryonic stem cells—ESC or hepatic stem cells—HSC, or mesenchymal stem cells—MSC). However, altered metabolic functions and incomplete differentiation of HLC are limitations of the model. Several models have been developed to mimic NALFD in vitro. NAFLD can be studied in 2- or 3-dimensional cell cultures by adding free fat acid (FFA), Bisphenol A or Valproate in the culture medium. New 3D models have been recently developed: spheroids are derived from different hepatic cell sources; hepatic organoids are produced by stem cell differentiation in parenchymal and non-parenchymal liver cells. Livers-on-a-chip are devices designed to mimic the physiological environment of the liver lobule: hepatocytes are placed inside a micro-scaffold, and a fluidic flow passes through the chip to reproduce blood circulation.CC BY · PubMed Central
Figure 2 Mouse models of NAFLD. Several mouse models have been described to mimic NAFLD in vivo. Both genetic and diet models are widely used to create experimental conditions of NAFLD and for preclinical drug testing. However, each model is specific as mice do no present all the typical features of NAFLD, from non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). High-fat diet (HFD) and Western diet-fed mice, as well as genetic ob/ob (leptin deficiency) and db/db (leptin receptor mutation) mouse models, display metabolic syndrome and severe steatosis but no liver inflammation or fibrosis. However, the Methionine- and Choline-deficient diet (MCD) and its derivate diets such as Choline Deficient Ethionine-supplemented (CDE) and Choline-deficient L-amino acid-defined (CDAA) diets promote liver inflammation and fibrosis. The stelic animal model (STAM) associates a toxic injection of streptozotocin with an HFD, resulting in HCC development. Other genetic models, such as Melanocortin-4 receptor (MC4R) deficiency or Sterol regulatory element-binding proteins (SREBP1c) overexpression, predispose to metabolic syndrome and obesity but need a second hit (such as HFD) to trigger NASH.
Figure 2 Mouse models of NAFLD. Several mouse models have been described to mimic NAFLD in vivo. Both genetic and diet models are widely used to create experimental conditions of NAFLD and for preclinical drug testing. However, each model is specific as mice do no present all the typical features of NAFLD, from non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). High-fat diet (HFD) and Western diet-fed mice, as well as genetic ob/ob (leptin deficiency) and db/db (leptin receptor mutation) mouse models, display metabolic syndrome and severe steatosis but no liver inflammation or fibrosis. However, the Methionine- and Choline-deficient diet (MCD) and its derivate diets such as Choline Deficient Ethionine-supplemented (CDE) and Choline-deficient L-amino acid-defined (CDAA) diets promote liver inflammation and fibrosis. The stelic animal model (STAM) associates a toxic injection of streptozotocin with an HFD, resulting in HCC development. Other genetic models, such as Melanocortin-4 receptor (MC4R) deficiency or Sterol regulatory element-binding proteins (SREBP1c) overexpression, predispose to metabolic syndrome and obesity but need a second hit (such as HFD) to trigger NASH.CC BY · PubMed Central

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Metadata

Authors
Soret, P.-A., Magusto, J., Housset, C., & Gautheron, J.
Affiliations
Inserm (FR)
Corresponding author
Gautheron, Jérémie
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2020-12-24
Volume
10
Issue
1
Pages
36
ISSN
2077-0383 (ISSN-L)
OpenAlex
W3116089396
Cited by
121
References
174
Citations by year
2026: 13 · 2025: 15 · 2024: 25 · 2023: 26 · 2022: 34 · 2021: 8
FWCI
2.48
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Fondation pour la Recherche Médicale (EQU2020-03010517, ARF20170938613)
  • Société Nationale Française de Gastro-Entérologie
  • Société Francophone du Diabète
  • Institut de Cardiométabolisme et Nutrition
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver physiology and pathology
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, in vitro model, in vivo models, cell model, mouse model, genetic mouse models, obesity, metabolic syndrome, liver fibrosis, liver cirrhosis, therapeutic target

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