From fatty liver to fibrosis: A tale of “second hit”

Figure 1 Oxidative stress is one of the most popular proposed mechanisms of hepatocellular injury and possible source of the oxidant stress as follows: increased free fatty acids supply, iron, intestinal bacterial over growth. NASH: Nonalcoholic steatohepatitis; NAFLD: Nonalcoholic fatty liver disease.

Figure 2 Logical and attractive hypothesis is that oxidative stress in TG-loaded hepatocytes is the cause of sustained injury with consequent NASH, fibrosis and cirrhosis. HSP: Heat shock proteins.