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Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 July 2019) | Viewed by 39629

Special Issue Editor

Dr. Alessandro Federico

E-Mail Website
Guest Editor
Department of Hepato-Gastroenterology, School of Medicine, University of Campania “Luigi Vanvitelli”,via Pansini 5, 80131 Naples, Italy
Interests: liver disease; NASH; HBV; HCV; HCC

Special Issue Information

Dear Colleagues,

Nowadays, non-alcoholic fatty liver disease (NAFLD) represents one of the most important causes of chronic liver damage, particularly in Western countries. Furthermore, it represents a “brick in the complex wall of the metabolic disease” that involves, not only the liver, but also other organs and apparatuses, exposing patients to the development of some morbidities and severe health conditions. In the last 10 years, the scientific community has acquired important knowledge regarding this topic in relation to the comprehension of underlying pathogenetic mechanisms or regarding the possibility of a non-invasive approach for the diagnosis until the research of a safety and effective therapy. Despite the important efforts, oriented to the comprehension of pathogenesis and treatment of this complex disease, some studies are needed in order to give physicians a complete clinical picture of this pathology.

This Special Issue seeks papers on pathogenetic factors involved in NAFLD development and worsening, analyses of the role of new non-invasive diagnostic procedures, and the possibility of using unconventional phytotherapic drugs to treat it.

Prof. Alessandro Federico
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Non-alcoholic fatty liver disease
  • Non-alcoholic steatohepatitis
  • Hepatocellular carcinoma
  • Oxidative stress
  • Endocrine interference
  • Bisphenol A
  • Fatty liver index
  • Nafld fibrosis score
  • Fibroscan
  • Silybin

Published Papers (6 papers)

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Review

26 pages, 812 KiB  
Review
Pharmacological Therapy of Non-Alcoholic Fatty Liver Disease: What Drugs Are Available Now and Future Perspectives
by Grazia Pennisi, Ciro Celsa, Federica Spatola, Marcello Dallio, Alessandro Federico and Salvatore Petta
Int. J. Environ. Res. Public Health 2019, 16(22), 4334; https://doi.org/10.3390/ijerph16224334 - 7 Nov 2019
Cited by 22 | Viewed by 5166
Abstract
The non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the most common cause of chronic liver disease as well as the first cause of liver transplantation. NAFLD is commonly associated with metabolic syndrome (MetS), and this is the most important reason why it [...] Read more.
The non-alcoholic fatty liver disease (NAFLD) is rapidly becoming the most common cause of chronic liver disease as well as the first cause of liver transplantation. NAFLD is commonly associated with metabolic syndrome (MetS), and this is the most important reason why it is extremely difficult to treat this disease bearing in mind the enormous amount of interrelationships between the liver and other systems in maintaining the metabolic health. The treatment of NAFLD is a key point to prevent NASH progression to advanced fibrosis, to prevent cirrhosis and to prevent the development of its hepatic complications (such as liver decompensation and HCC) and even extrahepatic one. A part of the well-known healthy effect of diet and physical exercise in this setting it is important to design the correct pharmaceutical strategy in order to antagonize the progression of the disease. In this regard, the current review has the scope to give a panoramic view on the possible pharmacological treatment strategy in NAFLD patients. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
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26 pages, 1040 KiB  
Review
NAFLD and Extra-Hepatic Comorbidities: Current Evidence on a Multi-Organ Metabolic Syndrome
by Valerio Rosato, Mario Masarone, Marcello Dallio, Alessandro Federico, Andrea Aglitti and Marcello Persico
Int. J. Environ. Res. Public Health 2019, 16(18), 3415; https://doi.org/10.3390/ijerph16183415 - 14 Sep 2019
Cited by 93 | Viewed by 6724
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its incidence is definitely increasing. NAFLD is a metabolic disease with extensive multi-organ involvement, whose extra-hepatic manifestations include type 2 diabetes mellitus, cardiovascular disease, obstructive sleep apnea, [...] Read more.
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its incidence is definitely increasing. NAFLD is a metabolic disease with extensive multi-organ involvement, whose extra-hepatic manifestations include type 2 diabetes mellitus, cardiovascular disease, obstructive sleep apnea, chronic kidney disease, osteoporosis, and polycystic ovarian syndrome. Recently, further evidence has given attention to pathological correlations not strictly related to metabolic disease, also incorporating in this broad spectrum of systemic involvement hypothyroidism, psoriasis, male sexual dysfunction, periodontitis, and urolithiasis. The most common cause of mortality in NAFLD is represented by cardiovascular disease, followed by liver-related complications. Therefore, clinicians should learn to screen and initiate treatment for these extra-hepatic manifestations, in order to provide appropriate multidisciplinary assessments and rigorous surveillance. This review evaluates the current evidence regarding extra-hepatic associations of NAFLD, focusing on the pathogenic hypothesis and the clinical implications. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
16 pages, 1437 KiB  
Review
Chemical Effect of Bisphenol A on Non-Alcoholic Fatty Liver Disease
by Marcello Dallio, Nadia Diano, Mario Masarone, Antonietta Gerarda Gravina, Vittorio Patanè, Mario Romeo, Rosa Di Sarno, Sonia Errico, Carla Nicolucci, Ludovico Abenavoli, Emidio Scarpellini, Luigi Boccuto, Marcello Persico, Carmelina Loguercio and Alessandro Federico
Int. J. Environ. Res. Public Health 2019, 16(17), 3134; https://doi.org/10.3390/ijerph16173134 - 28 Aug 2019
Cited by 39 | Viewed by 4561
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered a predominant chronic liver disease worldwide and a component of metabolic syndrome. Due to its relationship with multiple organs, it is extremely complex to precisely define its pathogenesis as well as to set appropriate therapeutic and [...] Read more.
Non-alcoholic fatty liver disease (NAFLD) is considered a predominant chronic liver disease worldwide and a component of metabolic syndrome. Due to its relationship with multiple organs, it is extremely complex to precisely define its pathogenesis as well as to set appropriate therapeutic and preventive strategies. Endocrine disruptors (EDCs) in general, and bisphenol A (BPA) in particular, are a heterogeneous group of substances, largely distributed in daily use items, able to interfere with the normal signaling of several hormones that seem to be related to type 2 diabetes mellitus (T2DM), obesity, and other metabolic disorders. It is reasonable to hypothesize a BPA involvement in the pathogenesis and evolution of NAFLD. However, its mechanisms of action as well as its burden in the vicious circle that connects obesity, T2DM, metabolic syndrome, and NAFLD still remain to be completely defined. In this review we analyzed the scientific evidence on this promising research area, in order to provide an overview of the harmful effects linked to the exposure to EDCs as well as to frame the role that BPA would have in all phases of NAFLD evolution. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
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19 pages, 781 KiB  
Review
Cardiovascular Risk in Non-Alcoholic Fatty Liver Disease: Mechanisms and Therapeutic Implications
by Claudio Tana, Stefano Ballestri, Fabrizio Ricci, Angelo Di Vincenzo, Andrea Ticinesi, Sabina Gallina, Maria Adele Giamberardino, Francesco Cipollone, Richard Sutton, Roberto Vettor, Artur Fedorowski and Tiziana Meschi
Int. J. Environ. Res. Public Health 2019, 16(17), 3104; https://doi.org/10.3390/ijerph16173104 - 26 Aug 2019
Cited by 120 | Viewed by 8820
Abstract
New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level [...] Read more.
New evidence suggests that non-alcoholic fatty liver disease (NAFLD) has a strong multifaceted relationship with diabetes and metabolic syndrome, and is associated with increased risk of cardiovascular events, regardless of traditional risk factors, such as hypertension, diabetes, dyslipidemia, and obesity. Given the pandemic-level rise of NAFLD—in parallel with the increasing prevalence of obesity and other components of the metabolic syndrome—and its association with poor cardiovascular outcomes, the question of how to manage NAFLD properly, in order to reduce the burden of associated incident cardiovascular events, is both timely and highly relevant. This review aims to summarize the current knowledge of the association between NAFLD and cardiovascular disease, and also to discuss possible clinical strategies for cardiovascular risk assessment, as well as the spectrum of available therapeutic strategies for the prevention and treatment of NAFLD and its downstream events. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
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9 pages, 336 KiB  
Review
Diet and Non-Alcoholic Fatty Liver Disease: The Mediterranean Way
by Ludovico Abenavoli, Luigi Boccuto, Alessandro Federico, Marcello Dallio, Carmelina Loguercio, Laura Di Renzo and Antonino De Lorenzo
Int. J. Environ. Res. Public Health 2019, 16(17), 3011; https://doi.org/10.3390/ijerph16173011 - 21 Aug 2019
Cited by 88 | Viewed by 8851
Abstract
Lifestyle interventions remain the first-line treatment for non-alcoholic fatty liver disease (NAFLD), even if the optimal alimentary regimen is still controversial. The interest in antioxidants has increased over time, and literature reports an inverse association between nutrients rich in antioxidants and the risk [...] Read more.
Lifestyle interventions remain the first-line treatment for non-alcoholic fatty liver disease (NAFLD), even if the optimal alimentary regimen is still controversial. The interest in antioxidants has increased over time, and literature reports an inverse association between nutrients rich in antioxidants and the risk of mortality due to non-communicable diseases, including NAFLD. Mediterranean diet (MD) is a model characterized by main consumption of plant-based foods and fish and reduced consumption of meat and dairy products. MD represents the gold standard in preventive medicine, probably due to the harmonic combination of many foods with antioxidant and anti-inflammatory properties. This regimen contributes substantially to the reduction of the onset of many chronic diseases as cardiovascular diseases, hypertension, type 2 diabetes mellitus, obesity, cancer, and NAFLD. The present review aims to clarify the intake of antioxidants typical of the MD and evaluate their effect on NAFLD. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
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Graphical abstract

13 pages, 491 KiB  
Review
Novel Insights into the Genetic Landscape of Nonalcoholic Fatty Liver Disease
by Alice Emma Taliento, Marcello Dallio, Alessandro Federico, Daniele Prati and Luca Valenti
Int. J. Environ. Res. Public Health 2019, 16(15), 2755; https://doi.org/10.3390/ijerph16152755 - 1 Aug 2019
Cited by 30 | Viewed by 4973
Abstract
Nonalcoholic fatty liver disease (NAFLD), the most common liver disorder worldwide, is epidemiologically associated with overweight, insulin resistance features and type 2 diabetes, and can progress to advanced liver fibrosis and hepatocellular carcinoma. Genetic factors play an important role in the development of [...] Read more.
Nonalcoholic fatty liver disease (NAFLD), the most common liver disorder worldwide, is epidemiologically associated with overweight, insulin resistance features and type 2 diabetes, and can progress to advanced liver fibrosis and hepatocellular carcinoma. Genetic factors play an important role in the development of NAFLD, which is a multifactorial disease. Several common naturally occurring variants modulating lipid and retinol metabolism in hepatocytes predispose to NAFLD development and progression, in particular those in PNPLA3, TM6SF2, MBOAT7, and HSD17B13. In addition, genetic variants that protect hepatic cells from oxidative stress modulate the susceptibility to progressive NAFLD. Although the molecular mechanisms linking these genetic variants with liver disease are not yet fully understood, hepatic fat has emerged as a major driver of the disease, while altered retinol metabolism and mitochondrial oxidative stress play a role in determining the development of advanced NAFLD. Full article
(This article belongs to the Special Issue Non-Alcoholic Fatty Liver Disease, from Pathogenesis to the Treatment Strategies: An Ever-changing World)
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