1
|
Zhou J, Tripathi M, Sinha RA, Singh BK, Yen PM. Gut microbiota and their metabolites in the progression of non-alcoholic fatty liver disease. ACTA ACUST UNITED AC 2021; 7:11. [PMID: 33490737 PMCID: PMC7116620 DOI: 10.20517/2394-5079.2020.134] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disorder worldwide. It comprises a spectrum of conditions that range from steatosis to non-alcoholic steatohepatitis, with progression to cirrhosis and hepatocellular carcinoma. Currently, there is no FDA-approved pharmacological treatment for NAFLD. The pathogenesis of NAFLD involves genetic and environmental/host factors, including those that cause changes in intestinal microbiota and their metabolites. In this review, we discuss recent findings on the relationship(s) of microbiota signature with severity of NAFLD and the role(s) microbial metabolites in NAFLD progression. We discuss how metabolites may affect NAFLD progression and their potential to serve as biomarkers for NAFLD diagnosis or therapeutic targets for disease management.
Collapse
Affiliation(s)
- Jin Zhou
- Program of Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Madhulika Tripathi
- Program of Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Rohit A Sinha
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Brijesh Kumar Singh
- Program of Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Paul M Yen
- Program of Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore 169857, Singapore.,Duke Molecular Physiology Institute, Durham, NC 27701, USA.,Duke University School of Medicine, Durham, NC 27710, USA
| |
Collapse
|
2
|
Ullah R, Rauf N, Nabi G, Ullah H, Shen Y, Zhou YD, Fu J. Role of Nutrition in the Pathogenesis and Prevention of Non-alcoholic Fatty Liver Disease: Recent Updates. Int J Biol Sci 2019; 15:265-276. [PMID: 30745819 PMCID: PMC6367556 DOI: 10.7150/ijbs.30121] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/24/2018] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is an acquired metabolic disease characterized by triglycerides (TGs) deposition in liver induced by other factors rather than alcohol consumption. NAFLD significantly contributes to liver diseases in children and adults. NAFLD pathogenesis is associated with age, gender, race and ethnicity. Insulin resistance, hyperinsulinemia, elevated plasma free fatty acids (FFAs), fatty liver, hepatocyte injury, liver inflammation, oxidative stress, mitochondrial dysfunction, imbalanced pro-inflammatory cytokines, and fibrosis are the characteristics of NAFLD. Factors including genetic and epigenetic pathways, sedentary lifestyle, sleep, and diet composition affect NAFLD pathogenesis. In this review, we discuss the aetiology, risk factors and pathogenesis of NAFLD. Special focus is given to macro and micro nutrition as causing factors and their role in the prevention of NAFLD pathogenesis.
Collapse
Affiliation(s)
- Rahim Ullah
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China.,Department of Neurobiology, Institute of Neuroscience, and the Collaborative Innovation Center for Brain Science, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Naveed Rauf
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China.,Department of Neurobiology, Institute of Neuroscience, and the Collaborative Innovation Center for Brain Science, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Ghulam Nabi
- Institute of Hydrobiology, the Chinese Academy of Sciences, Wuhan, 430072, China
| | - Hamid Ullah
- Laboratory of Reproductive Neuroendocrinology, Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Yi Shen
- Department of Neurobiology, Institute of Neuroscience, and the Collaborative Innovation Center for Brain Science, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yu-Dong Zhou
- Department of Neurobiology, Institute of Neuroscience, and the Collaborative Innovation Center for Brain Science, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Junfen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China
| |
Collapse
|
3
|
Predictive Role of Interleukin-18 in Liver Steatosis in Obese Children. Can J Gastroenterol Hepatol 2018; 2018:3870454. [PMID: 29854715 PMCID: PMC5944203 DOI: 10.1155/2018/3870454] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/05/2018] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Interleukin-18 (IL-18) is a proinflammatory cytokine associated with metabolic syndrome (MS). Nonalcoholic fatty liver disease (NAFLD) can be recognized as a feature of MS. MATERIAL AND METHODS Serum IL-18 concentration was evaluated in serum of 108 obese children, determined with ELISA, and referred to degree of liver steatosis in USG or total intrahepatic lipid content assessed by magnetic resonance proton spectroscopy (1HMRS). RESULTS Fatty liver was confirmed in 89 children with USG and in 72 with 1HMRS. IL-18 concentration demonstrated significantly higher values in patients than in controls. Significant correlations between IL-18 and ALT, GGT, triglycerides, hsCRP, and the degree of liver steatosis were demonstrated. NAFLD children had significantly higher level of IL-18, ALT, GGT, HOMA-IR, waist circumference, and total lipids content in 1HMRS than other obese children. IL-18 level was also significantly higher in obese children with advanced liver steatosis. Measurement of serum IL-18 showed ability to differentiate children with fatty liver from those without steatosis. CONCLUSION Elevated serum IL-18 concentration and its correlation with hepatocyte injury, systemic inflammation, and degree of liver steatosis support role in NAFLD pathomechanism. IL-18 can be considered to play a role in predicting advanced liver steatosis and fatty liver in obese children.
Collapse
|
4
|
Nobili V, Carpino G, De Peppo F, Caccamo R, Mosca A, Romito I, Overi D, Franchitto A, Onori P, Alisi A, Gaudio E. Laparoscopic Sleeve Gastrectomy Improves Nonalcoholic Fatty Liver Disease-Related Liver Damage in Adolescents by Reshaping Cellular Interactions and Hepatic Adipocytokine Production. J Pediatr 2018; 194:100-108.e3. [PMID: 29198531 DOI: 10.1016/j.jpeds.2017.10.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/08/2017] [Accepted: 10/13/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate whether the modulation of local cellular cross-talks and the modification of hepatic adipocytokine expression could mechanistically explain the improvement of liver histopathology after laparoscopic sleeve gastrectomy (LSG) in adolescents with nonalcoholic fatty liver disease (NAFLD). STUDY DESIGN Twenty obese (body mass index of ≥35 kg/m2) adolescents who underwent LSG and with biopsy-proven NAFLD were included. At baseline (T0) and 1 year after treatment, patients underwent clinical evaluation, blood tests, and liver biopsy. Hepatic progenitor cells, hepatic stellate cells (HSCs), macrophages, and adipocytokines were evaluated by immunohistochemistry and immunofluorescence. RESULTS Liver biopsy samples after LSG demonstrated a significant improvement of NAFLD Activity Score and fibrosis. Immunohistochemistry indicated a significant reduction of hepatocyte cell cycle arrest, ductular reaction, activated HSC, and macrophage number after LSG compared with T0. The activation state of HSC was accompanied by modification in the expression of the autophagy marker LC3. Hepatocyte expression of adiponectin was significant higher after LSG than into T0. Moreover, LSG caused decreased resistin expression in Sox9+ hepatic progenitor cells compared with T0. The number of S100A9+ macrophages was also reduced by LSG correlating with resistin expression. Finally, serum levels of proinflammatory cytokines significantly correlated with macrophages and activated HSC numbers. CONCLUSIONS The histologic improvement induced by LSG is associated with the reduced activation of local cellular compartments (hepatic progenitor cells, HSCs, and macrophages), thus, strengthening the role of cellular interactions and hepatic adipocytokine production in the pathogenesis of NAFLD.
Collapse
Affiliation(s)
- Valerio Nobili
- Hepatometabolic Unit, Bambino Gesù Children's Hospital, Rome, Italy; Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, Italy.
| | - Guido Carpino
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesco De Peppo
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, Palidoro, Roma, Italy
| | - Romina Caccamo
- Pediatric Surgery Unit, Bambino Gesù Children's Hospital, Palidoro, Roma, Italy
| | - Antonella Mosca
- Hepatometabolic Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Ilaria Romito
- Liver Research Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Diletta Overi
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Franchitto
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Onori
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| | - Anna Alisi
- Liver Research Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Eugenio Gaudio
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
5
|
Betancourt-Garcia MM, Arguelles A, Montes J, Hernandez A, Singh M, Forse RA. Pediatric Nonalcoholic Fatty Liver Disease: the Rise of a Lethal Disease Among Mexican American Hispanic Children. Obes Surg 2017; 27:236-244. [PMID: 27822768 DOI: 10.1007/s11695-016-2440-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hispanic children of Mexican origin have a high incidence of NAFLD. Susceptibility has been linked to a combination of factors including an increasing epidemic of obesity in children and adolescents, an allele substitution in the PNPLA3 gene that reduces hepatic lipid catabolism, and an altered microbiome that may increase hepatic endotoxins. The combination of NAFLD and portal vein toxins secondary to an indigenous gut microbiome appear to lead to the early occurrence of NASH, which progresses to cirrhosis and early hepatocellular carcinoma. Early detection and treatment of hepatic changes are needed. Given the success of gastric bypass in reducing body weight, modifying the gut microbiome, and improving NAFLD/NASH in adults, a trial of gastric bypass in predisposed pediatric candidates should be undertaken.
Collapse
Affiliation(s)
| | - Armando Arguelles
- Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA
| | - Jorge Montes
- Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA
| | - Ambrosio Hernandez
- Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA
| | - Manish Singh
- Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA
| | - R Armour Forse
- Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA
| |
Collapse
|
6
|
The Clinical Implications of Fatty Pancreas: A Concise Review. Dig Dis Sci 2017; 62:2658-2667. [PMID: 28791556 DOI: 10.1007/s10620-017-4700-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/27/2017] [Indexed: 12/19/2022]
Abstract
Fatty pancreas is a newly recognized condition which is poorly investigated until today as compared to nonalcoholic fatty liver disease. It is characterized by pancreatic fat accumulation and subsequent development of pancreatic and metabolic complications. Association of fatty pancreas have been described with type 2 diabetes mellitus, acute and chronic pancreatitis and even pancreatic carcinoma. In this review article, we provide an update on clinical implications, pathogenesis, diagnosis, treatment and outcomes.
Collapse
|
7
|
Mosca A, Nobili V, De Vito R, Crudele A, Scorletti E, Villani A, Alisi A, Byrne CD. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. J Hepatol 2017; 66:1031-1036. [PMID: 28214020 DOI: 10.1016/j.jhep.2016.12.025] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/01/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Recent research has suggested that dietary fructose intake may increase serum uric acid (UA) concentrations. Both UA concentration and fructose consumption maybe also increase in NAFLD. It is not known whether dietary fructose consumption and UA concentration are independently associated with non-alcoholic steatohepatitis (NASH). Our aim was to investigate the factors associated with NASH in children and adolescents with proven NAFLD, and to test whether UA concentrations and fructose consumption are independently associated with NASH. METHODS Obese children with NAFLD were studied (n=271). NASH was diagnosed by a NAFLD activity score ⩾5 and the fatty liver inhibition of progression (FLIP) algorithm. Fructose consumption (g/day) was assessed by food frequency questionnaire, and UA (mg/dl) was measured in serum. Binary logistic regression with adjustment for covariates and potential confounders was undertaken to test factors independently associated with NASH. RESULTS NASH occurred in 37.6% of patients. Hyperuricaemia (UA ⩾5.9mg/dl) was present in 47% of patients with NASH compared with 29.7% of non-NASH patients (p=0.003). Both UA concentration (OR=2.488, 95% CI: 1.87-2.83, p=0.004) and fructose consumption (OR=1.612, 95% CI 1.25-1.86, p=0.001) were independently associated with NASH, after adjustment for multiple (and all) measured confounders. Fructose consumption was independently associated with hyperuricaemia (OR=2.021, 95% CI: 1.66-2.78, p=0.01). These data were confirmed using the FLIP algorithm. CONCLUSIONS Both dietary fructose consumption and serum UA concentrations are independently associated with NASH. Fructose consumption was the only factor independently associated with serum UA concentration. LAY SUMMARY Currently, it is not known whether dietary fructose consumption and uric acid (UA) concentration are linked with non-alcoholic steatohepatitis (NASH) in children and adolescents. Our aim was to test whether UA concentrations and fructose consumption are independently associated with NASH in children and adolescents with proven non-alcoholic fatty liver disease (NAFLD). We show that both dietary fructose consumption and serum UA concentrations are independently associated with NASH and fructose consumption was independently linked with high serum UA concentrations.
Collapse
Affiliation(s)
- Antonella Mosca
- Hepatometabolic Unit - Bambino Gesù Children's Hospital, Rome, Italy
| | - Valerio Nobili
- Hepatometabolic Unit - Bambino Gesù Children's Hospital, Rome, Italy; Histopathology Unit, Bambino Gesù Hospital, IRCCS, Rome, Italy.
| | - Rita De Vito
- Histopathology Unit, Bambino Gesù Hospital, IRCCS, Rome, Italy
| | - Annalisa Crudele
- Liver Research Unit - Bambino Gesù Children's Hospital, Rome, Italy
| | - Eleonora Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Alberto Villani
- Paediatrics and Infectious Disease, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Anna Alisi
- Liver Research Unit - Bambino Gesù Children's Hospital, Rome, Italy
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| |
Collapse
|
8
|
Alqahtani A, Elahmedi M, Alswat K, Arafah M, Fagih M, Lee J. Features of nonalcoholic steatohepatitis in severely obese children and adolescents undergoing sleeve gastrectomy. Surg Obes Relat Dis 2017; 13:1599-1609. [PMID: 28600116 DOI: 10.1016/j.soard.2017.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/10/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is an underrecognized co-morbidity of obesity. The characteristic features and severity of NAFLD in severe childhood obesity remain unknown. OBJECTIVES To investigate features of NAFLD in obese children and identify predictors of significant disease. SETTING Academic center with a standardized pathway for pediatric bariatric surgery and a dedicated multidisciplinary team. DESIGN This is a baseline cross-sectional analysis for a data set obtained from a prospective clinical outcome study that included severely obese children (≤14 yr of age) and adolescents (14-21 yr of age) who underwent laparoscopic sleeve gastrectomy between March 2008 and March 2015. Patients with syndromic obesity, history of alcohol intake, parenteral nutrition, liver disease, intake of medications that may affect NAFLD and weight, and insufficient tissue biopsy were excluded. Prevalence and features of nonalcoholic steatohepatitis (NASH) and clinically significant liver fibrosis in different pediatric age groups and noninvasive predictors in severe childhood obesity were evaluated. RESULTS The 296 patients in the study group (1:1 sex distribution) had a mean body mass index and age of 48.4±9.8 kg/m2 and 14.5±3.6 years, respectively. According to histopathology assessment, 225 (76%) patients had NAFLD, of whom 118 patients (39.9% of the total cohort) had NASH. Additionally, 110 (37.2%) had clinically significant (stage 2+) fibrosis and 256 (86.5%) had portal inflammation. Those with NASH were younger than those without NASH (P = .02; prevalence of NASH in children aged≤10 yr = 64.9%) and were more likely to be male (P = .003). Of children aged≤10 years, 60% had clinically significant fibrosis compared with 32% of older patients (P = .03). High-density lipoproteins, triglycerides, glycated hemoglobin, alanine transaminase, and systolic and diastolic blood pressure levels were most predictive of fibrosis. For NASH, triglycerides, homeostatic model assessment of insulin resistance, glycated hemoglobin, alkaline phosphatase, aspartate transaminase, and alanine transaminase were most predictive. CONCLUSIONS In our setting, 65% of severely obese young children had NASH, and 60% had clinically significant liver fibrosis. Young age, male sex, and features of metabolic syndrome were significantly associated with NASH and liver fibrosis in severely obese pediatric patients.
Collapse
Affiliation(s)
- Aayed Alqahtani
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Mohamed Elahmedi
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alswat
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Maha Arafah
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mosa Fagih
- Department of Anatomic Pathology, College of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Jaehoon Lee
- College of Education, Texas Tech University, Lubbock, Texas
| |
Collapse
|
9
|
Ceccarelli S, Panera N, Mina M, Gnani D, De Stefanis C, Crudele A, Rychlicki C, Petrini S, Bruscalupi G, Agostinelli L, Stronati L, Cucchiara S, Musso G, Furlanello C, Svegliati-Baroni G, Nobili V, Alisi A. LPS-induced TNF-α factor mediates pro-inflammatory and pro-fibrogenic pattern in non-alcoholic fatty liver disease. Oncotarget 2016; 6:41434-52. [PMID: 26573228 PMCID: PMC4747165 DOI: 10.18632/oncotarget.5163] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/25/2015] [Indexed: 02/07/2023] Open
Abstract
Lipopolysaccharide (LPS) is currently considered one of the major players in non-alcoholic fatty liver disease (NAFLD) pathogenesis and progression. Here, we aim to investigate the possible role of LPS-induced TNF-α factor (LITAF) in inducing a pro-inflammatory and pro-fibrogenic phenotype of non-alcoholic steatohepatitis (NASH).We found that children with NAFLD displayed, in different liver-resident cells, an increased expression of LITAF which correlated with histological traits of hepatic inflammation and fibrosis. Total and nuclear LITAF expression increased in mouse and human hepatic stellate cells (HSCs). Moreover, LPS induced LITAF-dependent transcription of IL-1β, IL-6 and TNF-α in the clonal myofibroblastic HSC LX-2 cell line, and this effect was hampered by LITAF silencing. We showed, for the first time in HSCs, that LITAF recruitment to these cytokine promoters is LPS dependent. However, preventing LITAF nuclear translocation by p38MAPK inhibitor, the expression of IL-6 and TNF-α was significantly reduced with the aid of p65NF-ĸB, while IL-1β transcription exclusively required LITAF expression/activity. Finally, IL-1β levels in plasma mirrored those in the liver and correlated with LPS levels and LITAF-positive HSCs in children with NASH.In conclusion, a more severe histological profile in paediatric NAFLD is associated with LITAF over-expression in HSCs, which in turn correlates with hepatic and circulating IL-1β levels outlining a panel of potential biomarkers of NASH-related liver damage. The in vitro study highlights the role of LITAF as a key regulator of the LPS-induced pro-inflammatory pattern in HSCs and suggests p38MAPK inhibitors as a possible therapeutic approach against hepatic inflammation in NASH.
Collapse
Affiliation(s)
- Sara Ceccarelli
- Liver Research Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Nadia Panera
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Marco Mina
- Predictive Models for Biomedicine and Environment Unit, Fondazione Bruno Kessler, Trento, Italy
| | - Daniela Gnani
- Liver Research Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Cristiano De Stefanis
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Annalisa Crudele
- Liver Research Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Chiara Rychlicki
- Department of Gastroenterology, Polytechnic University of Marche, Ancona, Italy
| | - Stefania Petrini
- Confocal Microscopy Core Facility, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Giovannella Bruscalupi
- Department of Biology and Biotechnology "C. Darwin", Sapienza University of Rome, Rome, Italy
| | - Laura Agostinelli
- Department of Gastroenterology, Polytechnic University of Marche, Ancona, Italy
| | - Laura Stronati
- Department of Radiobiology and Human Health, ENEA, Rome, Italy
| | - Salvatore Cucchiara
- Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy
| | | | - Cesare Furlanello
- Predictive Models for Biomedicine and Environment Unit, Fondazione Bruno Kessler, Trento, Italy
| | - Gianluca Svegliati-Baroni
- Department of Gastroenterology, Polytechnic University of Marche, Ancona, Italy.,Center for Obesity, Polytechnic University of Marche, Ancona, Italy
| | - Valerio Nobili
- Hepato-Metabolic Disease Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| | - Anna Alisi
- Liver Research Unit, "Bambino Gesù" Children's Hospital-IRCCS, Rome, Italy
| |
Collapse
|
10
|
Della Corte C, Mosca A, Majo F, Lucidi V, Panera N, Giglioni E, Monti L, Stronati L, Alisi A, Nobili V. Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat. Clin Endocrinol (Oxf) 2015. [PMID: 26201937 DOI: 10.1111/cen.12862] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the metabolic effects of fatty pancreas (nonalcoholic fatty pancreas disease - NAFPD) in a group of obese paediatric patients with nonalcoholic fatty liver disease (NAFLD). METHODS We included 121 consecutive children with echographic evidence of hepatic steatosis. All patients underwent to abdominal ultrasound to evaluate pancreatic echogenic pattern. We divided the patients into two groups on the basis of the presence of fatty pancreas. In all patients liver function tests, lipid and gluco-insulinemic profile were evaluated. A selected subset of patients (67) underwent to liver biopsy. RESULTS Of these 121 patients, 58 showed NAFPD and 63 patients exhibited a normal pancreatic echogenic pattern. No differences were found in age, transaminases serum levels, lipid profile and pancreatic enzymes between the two groups. The patients with NAFPD had a significantly higher z-BMI, fasting insulin, insulin resistance (HOMA-IR) and lower ISI respect to the group without fatty pancreas. The patients with fatty pancreas showed a more advanced form of liver disease, with higher values of fibrosis, ballooning and NAS score with respect to the group without NAFPD. CONCLUSIONS Our study demonstrated that NAFPD is a frequent condition in obese paediatric patients affected by NAFLD. Our data suggest that pancreatic fat should not be considered an inert accumulation of fat, but as an additional factor able to affect glucose metabolism and severity of liver disease, increasing the risk of develop metabolic syndrome.
Collapse
Affiliation(s)
- C Della Corte
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - A Mosca
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - F Majo
- Cystic Fibrosis Unit, Pediatric Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - V Lucidi
- Cystic Fibrosis Unit, Pediatric Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - N Panera
- Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - E Giglioni
- Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Monti
- Liver and Digestive Radiology Unit, Department of Imaging, Bambino Gesu' Children's Hospital, IRCCS, Rome, Italy
| | - L Stronati
- Institute of Biology, Molecular Medicine and Nanobiotechnology, CNR, Rome, Italy
| | - A Alisi
- Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| | - V Nobili
- Hepato-Metabolic Department, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
| |
Collapse
|
11
|
|
12
|
Cianfarani S, Inzaghi E, Alisi A, Germani D, Puglianiello A, Nobili V. Insulin-like growth factor-I and -II levels are associated with the progression of nonalcoholic fatty liver disease in obese children. J Pediatr 2014; 165:92-8. [PMID: 24607243 DOI: 10.1016/j.jpeds.2014.01.052] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 12/03/2013] [Accepted: 01/24/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To correlate circulating levels of insulin-like growth factor (IGF)-I, IGF-II, and IGF binding protein (IGFBP)-3 in a population of obese children with biopsy-proven nonalcoholic fatty liver disease (NAFLD) with clinical, biochemical, and histological features. STUDY DESIGN We conducted a cross-sectional study at the Hepatometabolic Unit of the Bambino Gesù Children's Hospital, Rome, Italy. Obese children (42 girls and 57 boys) underwent liver biopsy, anthropometry, biochemical assessment, and IGF system evaluation. Serum concentrations of IGF-I, IGF-II, and IGFBP-3 were measured. The liver biopsy features of each case were graded according to the NAFLD Activity Scoring system. The degrees of steatosis, inflammation, ballooning, and fibrosis were calculated. RESULTS Nonalcoholic steatohepatitis was diagnosed in 14/99 obese subjects. Stepwise regression analysis revealed that IGF-I was the major predictor of ballooning (β = -0.463; P < .0001) and NAFLD activity score (β = -0.457; P < .0001), IGF-I/IGFBP-3 ratio was the major predictor of liver inflammation (β = -0.285; P = .005), and IGF-II was the major predictor of liver fibrosis (β = 0.343; P < .005). CONCLUSION Circulating levels of IGF-I and IGF-II are associated with the histological stages of NAFLD and may represent novel markers of liver damage progression in obese children.
Collapse
Affiliation(s)
- Stefano Cianfarani
- Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
| | - Elena Inzaghi
- Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
| | - Anna Alisi
- Hepatometabolic Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Daniela Germani
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | - Valerio Nobili
- Hepatometabolic Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
| |
Collapse
|
13
|
van Rijn RR, Nievelstein RAJ. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas. Eur J Radiol 2014; 83:1570-81. [PMID: 24780818 DOI: 10.1016/j.ejrad.2014.03.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 03/21/2014] [Indexed: 02/06/2023]
Abstract
In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the US study a clinical history can be obtained strongly adds to the value of the US exam. This does require investment in time and expertise and ideally a paediatric radiologist performing the exam. In this review the role of ultrasonography (US) of the liver, biliary tract and pancreas in children is discussed.
Collapse
Affiliation(s)
- R R van Rijn
- Department of Radiology, Emma Children's Hospital - Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - R A J Nievelstein
- Department of Radiology, Wilhelmina Children's Hospital - University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| |
Collapse
|