Neokosmidis G, Cholongitas E, Tziomalos K. Acetyl-CoA carboxylase inhibitors in non-alcoholic steatohepatitis: Is there a benefit? World J Gastroenterol 2021; 27(39): 6522-6526 [PMID: 34754150 DOI: 10.3748/wjg.v27.i39.6522]
Corresponding Author of This Article
Konstantinos Tziomalos, MD, MSc, PhD, Associate Professor, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, Thessaloniki 54636, Greece. ktziomalos@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Frontier
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Georgios Neokosmidis, Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
Evangelos Cholongitas, First Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens 11527, Greece
Author contributions: Neokosmidis G drafted the editorial; Cholongitas E and Tziomalos K critically revised the draft.
Conflict-of-interest statement: We have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Konstantinos Tziomalos, MD, MSc, PhD, Associate Professor, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi street, Thessaloniki 54636, Greece. ktziomalos@yahoo.com
Received: March 28, 2021 Peer-review started: March 28, 2021 First decision: June 14, 2021 Revised: June 28, 2021 Accepted: September 22, 2021 Article in press: September 22, 2021 Published online: October 21, 2021
Abstract
De novo lipogenesis (DNL) plays an important role in the pathogenesis of hepatic steatosis and also appears to be implicated in hepatic inflammation and fibrosis. Accordingly, the inhibition of acetyl-CoA carboxylase, which catalyzes the rate-limiting step of DNL, might represent a useful approach in the management of patients with nonalcoholic fatty liver disease (NAFLD). Animal studies and preliminary data in patients with NAFLD consistently showed an improvement in steatosis with the use of these agents. However, effects on fibrosis were variable and an increase in plasma triglyceride levels was observed. Therefore, more long-term studies are needed to clarify the role of these agents in NAFLD and to determine their risk/benefit profile.
Core Tip: Acetyl-CoA carboxylase inhibitors suppress de novo lipogenesis resulting in improvement in hepatic steatosis in both animal models and in patients with nonalcoholic fatty liver disease. However, the effects of these agents on hepatic fibrosis are inconsistent and they increase plasma triglyceride levels, casting doubt on their risk/ benefit profile.
