Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 3777-3785
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3777
Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis
Yoshihisa Takahashi, Keiichiro Sugimoto, Hiroshi Inui, Toshio Fukusato
Yoshihisa Takahashi, Toshio Fukusato, Department of Pathology, Teikyo University School of Medicine, Tokyo 173-8605, Japan
Keiichiro Sugimoto, Research and Development Center, Nagaoka Perfumery Co. Ltd., Ibaraki, Osaka 567-0005, Japan
Keiichiro Sugimoto, Hiroshi Inui, Center for Research and Development of Bioresources, Osaka Prefecture University, Sakai, Osaka 599-8570, Japan
Hiroshi Inui, Department of Clinical Nutrition, College of Health and Human Sciences, Osaka Prefecture University, Habikino, Osaka 583-8555, Japan
Author contributions: Takahashi Y wrote the manuscript; Sugimoto K, Inui H and Fukusato T checked and revised the manuscript.
Conflict-of-interest: We declare that we have no competing interests.
Open-Access: 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/
Correspondence to: Yoshihisa Takahashi, Associate Professor, MD, Department of Pathology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. ytakaha-tky@umin.ac.jp
Telephone: +81-3-39641211 Fax: +81-3-39649622
Received: November 25, 2014
Peer-review started: November 26, 2014
First decision: December 26, 2014
Revised: January 8, 2015
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: April 7, 2015
Abstract

Nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is considered to be a hepatic manifestation of metabolic syndrome, and its incidence is rapidly increasing worldwide. It is currently the most common chronic liver disease. NASH can progress to liver cirrhosis and hepatocellular carcinoma, and may result in liver-related death. Currently, the principal treatment for NAFLD/NASH is lifestyle modification by diet and exercise. However, pharmacological therapy is indispensable because obese patients with NAFLD often have difficulty maintaining improved lifestyles. The pathogenesis of NAFLD/NASH has not been completely elucidated. However, insulin resistance, inflammatory cytokines, and oxidative stress are thought to be important in the development and/or progression of the disease. Currently, insulin sensitizers (thiazolidinediones) and antioxidants (vitamin E) seem to be the most promising therapeutic agents for NAFLD/NASH, and lipid-lowering drugs, pentoxifylline, angiotensin receptor blockers, and n-3 polyunsaturated fatty acids also have promise. However, there is a lack of consensus regarding the most effective and appropriate pharmacotherapy for NAFLD/NASH. Animal experiments suggest that herbal medicines and natural products may be promising therapeutic agents for NAFLD/NASH, but their efficacy and safety are yet to be investigated in human studies. In this paper, we review the existing and potential pharmacological therapies for NAFLD/NASH.

Keywords: Pharmacological therapy, Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Vitamin E, Thiazolidinedione

Core tip: Nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is considered to be a hepatic manifestation of metabolic syndrome. Currently, the principal treatment for NAFLD/NASH is lifestyle modification by diet and exercise. However, establishment of pharmacological therapy is indispensable. Currently, insulin sensitizers (thiazolidinediones) and antioxidants (vitamin E) seem to be the most promising agents for treating NAFLD/NASH, and lipid-lowering drugs, pentoxifylline, angiotensin receptor blockers, and n-3 polyunsaturated fatty acids also have promise. However, there is a lack of consensus regarding the most effective and appropriate pharmacotherapy for NAFLD/NASH. Here, we review the existing and potential pharmacological therapies for NAFLD/NASH.