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Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology

The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of...

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Autores principales: Yoon, In Cheol, Eun, Jong Ryeol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yeungnam University College of Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784634/
https://www.ncbi.nlm.nih.gov/pubmed/31620616
http://dx.doi.org/10.12701/yujm.2019.00171
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author Yoon, In Cheol
Eun, Jong Ryeol
author_facet Yoon, In Cheol
Eun, Jong Ryeol
author_sort Yoon, In Cheol
collection PubMed
description The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology.
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spelling pubmed-67846342019-10-16 Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology Yoon, In Cheol Eun, Jong Ryeol Yeungnam Univ J Med Review Article The paradigm of chronic liver diseases has been shifting. Although hepatitis B and C viral infections are still the main causes of liver cirrhosis and hepatocellular carcinoma (HCC), the introduction of effective antiviral drugs may control or cure them in the near future. In contrast, the burden of nonalcoholic fatty liver disease (NAFLD) has been increasing for decades, and 25 to 30% of the general population in Korea is estimated to have NAFLD. Over 10% of NAFLD patients may have nonalcoholic steatohepatitis (NASH), a severe form of NAFLD. NASH can progress to cirrhosis and HCC. NASH is currently the second leading cause to be placed on the liver transplantation list in the United States. NAFLD is associated with obesity, type 2 diabetes, dyslipidemia, and metabolic syndrome. The pathophysiology is complex and associated with lipotoxicity, inflammatory cytokines, apoptosis, and insulin resistance. The only proven effective treatment is weight reduction by diet and exercise. However, this may not be effective for advanced fibrosis or cirrhosis. Therefore, effective drugs are urgently needed for treating these conditions. Unfortunately, no drugs have been approved for the treatment of NASH. Many pharmaceutical companies are trying to develop new drugs for the treatment of NASH. Some of them are in phase 2 or 3 clinical trials. Here, pharmacologic therapies in clinical trials, as well as the basic principles of drug therapy, will be reviewed, focusing on pathophysiology. Yeungnam University College of Medicine 2019-04-11 /pmc/articles/PMC6784634/ /pubmed/31620616 http://dx.doi.org/10.12701/yujm.2019.00171 Text en Copyright © 2019 Yeungnam University College of Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Yoon, In Cheol
Eun, Jong Ryeol
Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title_full Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title_fullStr Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title_full_unstemmed Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title_short Pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
title_sort pharmacologic therapy for nonalcoholic steatohepatitis focusing on pathophysiology
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784634/
https://www.ncbi.nlm.nih.gov/pubmed/31620616
http://dx.doi.org/10.12701/yujm.2019.00171
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