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Review
. 2021 Dec 2;10(12):3401.
doi: 10.3390/cells10123401.

Progressive Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Daryl Ramai  1 , Antonio Facciorusso  2 , Erika Vigandt  3 , Bryan Schaf  3 , Waleed Saadedeen  3 , Aditya Chauhan  3 , Sara di Nunzio  4 , Aashni Shah  4 , Luca Giacomelli  4 , Rodolfo Sacco  2
Affiliations
Review

Progressive Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Daryl Ramai et al. Cells. .

Abstract

Non-alcoholic steatohepatitis (NASH) is a chronic and progressive form of non-alcoholic fatty liver disease. Its global incidence is increasing and makes NASH an epidemic and a public health threat. Non-alcoholic fatty liver disease is associated with major morbidity and mortality, with a heavy burden on quality of life and liver transplant requirements. Due to repeated insults to the liver, patients are at risk for developing hepatocellular carcinoma. The progression of NASH was initially defined according to a two-hit model involving an initial development of steatosis, followed by a process of lipid peroxidation and inflammation. In contrast, current evidence proposes a "multi-hit" or "multi-parallel hit" model that includes multiple pathways promoting progressive fibrosis and oncogenesis. This model includes multiple cellular, genetic, immunological, metabolic, and endocrine pathways leading to hepatocellular carcinoma development, underscoring the complexity of this disease.

Keywords: hepatocellular cancer; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Risk factors and proposed mechanisms for non-alcohol steatosis (NASH) progressive liver fibrosis.
Figure 2
Figure 2
Role of insulin resistance in hepatic steatosis.
Figure 3
Figure 3
Role of androgens and estrogens in liver fibrosis and tumorigenesis. AR: androgen receptor, CCRK: cell cycle-related kinase.
See this image and copyright information in PMC

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