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Review
. 2015 Apr 7;21(13):3777-85.
doi: 10.3748/wjg.v21.i13.3777.

Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Yoshihisa Takahashi  1 , Keiichiro Sugimoto  1 , Hiroshi Inui  1 , Toshio Fukusato  1
Affiliations
Review

Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

Yoshihisa Takahashi et al. World J Gastroenterol. .

Abstract

Nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is considered to be a hepatic manifestation of metabolic syndrome, and its incidence is rapidly increasing worldwide. It is currently the most common chronic liver disease. NASH can progress to liver cirrhosis and hepatocellular carcinoma, and may result in liver-related death. Currently, the principal treatment for NAFLD/NASH is lifestyle modification by diet and exercise. However, pharmacological therapy is indispensable because obese patients with NAFLD often have difficulty maintaining improved lifestyles. The pathogenesis of NAFLD/NASH has not been completely elucidated. However, insulin resistance, inflammatory cytokines, and oxidative stress are thought to be important in the development and/or progression of the disease. Currently, insulin sensitizers (thiazolidinediones) and antioxidants (vitamin E) seem to be the most promising therapeutic agents for NAFLD/NASH, and lipid-lowering drugs, pentoxifylline, angiotensin receptor blockers, and n-3 polyunsaturated fatty acids also have promise. However, there is a lack of consensus regarding the most effective and appropriate pharmacotherapy for NAFLD/NASH. Animal experiments suggest that herbal medicines and natural products may be promising therapeutic agents for NAFLD/NASH, but their efficacy and safety are yet to be investigated in human studies. In this paper, we review the existing and potential pharmacological therapies for NAFLD/NASH.

Keywords: Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Pharmacological therapy; Thiazolidinedione; Vitamin E.

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Figures

Figure 1
Figure 1
Effects of a Japanese herbal medicines on liver histology in an animal model of nonalcoholic steatohepatitis. A: When db/db mice were fed a methionine- and choline-deficient (MCD) diet, marked hepatic steatosis and scattered foci of lobular inflammation (arrows) were induced; B: When juzentaihoto was added to the MCD diet, liver histology markedly improved (hematoxylin and eosin staining).
See this image and copyright information in PMC

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