Nonalcoholic Fatty Liver Disease: New Insights

Ramón Anibal Rodrigo Salinas (Editor)
Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Independencia 1027, Casilla 70058, Santiago, Chile

Series: Hepatology Research and Clinical Developments
BISAC: MED114000

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Non-alcoholic fatty liver disease, or NAFLD, represents a spectrum of pathologic liver histologic findings ranging from the simple accumulation of fat, known as steatosis, to nonalcoholic steatohepatitis and cirrhosis. It is estimated that NAFLD in all of its forms would have a 20% prevalence worldwide, but the evidence suggests a higher rate for developed countries, exceeding 30% for the US general population. Major risk factors for NAFLD, such as ageing, obesity and insulin resistance, are projected to increase in the following decades, causing the prevalence and relevance of NAFLD to rise in the future.

In obese populations and type 2 diabetes patients, the prevalence of this disease exceeds 70%. NAFLD has been called the “silent epidemic” for its lack of symptoms, relatively complex diagnosis and its deleterious effects. The association between NAFLD with cardiovascular diseases, energy metabolism disorders and polycystic ovarian syndrome has promoted the inclusion of this liver pathology within the metabolic syndrome. From a biochemical point of view, current evidence suggests the existence of a bidirectional causal relationship between NAFLD and oxidative stress, where various alterations energy metabolism and important inflammatory components are involved. An abnormal glucose and fatty acid metabolism lead to glucotoxicity and lipotoxicity, respectively, which promote oxidative stress through different pathways.

Oxidative stress induces the expression of pro-inflammatory mediators, including transcription factors and cytokines, which trigger an immune activation, a key step in the transition from simple steatosis to steatohepatitis. An early diagnosis and optimal therapy are essential for NAFLD treatment. First-line treatment of NAFLD focuses on lifestyle changes. Weight reduction through an increase in physical activity and/or nutritional management is considered safe and effective, but pharmacological management of common comorbidities such as hyperglycemia, dyslipidemias and hypertension are also essential. The key role of oxidative stress in NAFLD pathophysiology suggests that antioxidant interventions based in natural substances such as polyphenols would be effective. Recently, it was shown that the antioxidant properties of these compounds are beyond their free radical scavenging.

This book presents an update of research advances contributing to a better understanding of relevant clinical models of NAFLD, particularly, the disorder in energy metabolism and the role of oxidative stress. It also highlights the clinical and pathophysiological association between NAFLD and the metabolic syndrome, and presents an overview of current diagnosis and treatment and the future avenues for the management of this disease.
(Imprint: Nova Biomedical)

Preface
pp. vii-viii

Chapter 1
Current Diagnosis and Therapy in Nonalcoholic Fatty Liver Disease
(Juan Guillermo Gormaz, Matías Libuy, Nicolás Valls, Caterina Contreras, Camilo Sotomayor, Cristobal Mülchi and Andrés Carreño, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile, and others)
pp. 1-20

Chapter 2
Molecular Mechanisms in the Development and Progression of Nonalcoholic Fatty Liver Disease
(Daniel Hasson, Diego Escudero and Felipe Feliu, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile)
pp. 21-46

Chapter 3
Role of Oxidative Stress and Inflammation in the Pathophysiology of Nonalcoholic Fatty Liver Disease
(Cristóbal Alegría, David Gil-Becerra and Ramón Rodrigo, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile)
pp. 47-78

Chapter 4
Non-Alcoholic Fatty Liver Disease and the Metabolic Syndrome
(Daniel Hasson, Felipe Feliú and Juan G. Gormaz, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Chile)
pp. 79-106

Chapter 5
Non-Alcoholic Fatty Liver Disease: Novel Therapeutic Approaches
(Juan Guillermo Gormaz, Matías Libuy, Nicolás Valls, Sergio Vera, Rolando Martínez, Felipe Maira and Ramón Rodrigo, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile)
pp. 107-122

Chapter 6
The Potential Role of Polyphenols in Nonalcoholic Fatty Liver Disease Treatment
(Sebastián Quintremil, Biochemistry and Molecular Biology Department, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Chile)
pp. 123-140

Index
pp. 141-143

The book will have an academic level that spans from Third and Fourth year college students coursing a degree in health sciences to health professionals without specialization in hepatology, with interest in expanding their knowledge about NAFLD.

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