Iron in fatty liver and in the metabolic syndrome: a promising therapeutic target

Fatty liver induced by free radicals and lipid peroxidation

An excessive accumulation of fat in the liver leads to chronic liver injury such as non-alcoholic fatty liver disease (NAFLD), which is an important medical problem affecting many populations worldwide. Oxidative stress has been implicated in the pathogenesis of NAFLD, but the exact nature of active species and the underlying mechanisms have not been elucidated. It was previously found that the administration of free radical-generating azo compound to mice induced accumulation of fat droplet in the liver. The present study was performed aiming at elucidating the changes of lipid classes and fatty acid composition and also measuring the levels of lipid peroxidation products in the liver induced by azo compound administration to mouse. The effects of azo compound on the liver were compared with those induced by high fat diet, a well-established cause of NAFLD. Azo compounds given to mice either by intraperitoneal administration or by dissolving to drinking water induced triacylglycerol (TG) increase and concomitant phospholipid decrease in the liver, whose pattern was quite similar to that induced by high fat diet. Lipid peroxidation products such as hydroxyoctadecadienoic acid and hydroxyeicosatetraenoic acid were increased in the liver in association with the increase in TG. These results show that free radicals as well as high fat diet induce fatty liver by similar mechanisms, in which lipid peroxidation may be involved.

Iron and steatohepatitis

As the main iron storage site in the body and the main source of the iron-regulatory hormone, hepcidin, the liver plays a pivotal role in iron homeostasis. A variable degree of hepatic iron accumulation has long been recognized in a number of chronic liver diseases. Both alcoholic and non-alcoholic steatohepatitis display increased iron deposits in the liver, with an hepatocellular, mesenchymal, or mixed pattern, and recent reports have documented a concomitant aberrant hepcidin expression that could be linked to different coincidental pathogenic events (e.g. the etiological agent itself, necroinflammation, metabolic derangements, genetic predisposition). The present study reviews the pathogenic mechanisms of iron accumulation in steatohepatitis during alcoholic and non-alcoholic liver disease and the role of excess iron in chronic disease progression.