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Pharmaceuticals
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New Advances in the Treatment of Nonalcoholic Fatty Liver Disease
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New Advances in the Treatment of Nonalcoholic Fatty Liver Disease

A special issue of Pharmaceuticals (ISSN 1424-8247).

Deadline for manuscript submissions: closed (30 June 2018)

Special Issue Editor

Prof. Dr. Ludovico Abenavoli

E-Mail Website
Guest Editor
Department of Health Sciences, University “Magna Græcia”, Campus Germaneto, I-88100 Catanzaro, Italy
Interests: nonalcoholic fatty liver disease; alcoholic liver disease; gut microbiota; Mediterranean diet; nutrition; COVID-19; probiotic
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nonalcoholic fatty liver disease (NAFLD), is the most common liver disease worldwide. The estimated prevalence of NAFLD in the Western world, and in the urban areas of developing countries, is around 25% in the general population.

NAFLD is now considered the hepatic border of metabolic syndrome, supported by a high-calorie dietetic regimen, in the presence of a genetic profile characterized by predisposing polymorphisms. The “multi parallel hit” pathogenetic hypothesis of NAFLD, suggest that fat accumulation in the hepatocytes exposes the liver to oxidative stress with reactive oxygen species production, inflammation unbalance, cellular necrosis and, finally, fibrosis.

Several pharmacological treatments have been proposed in the last two decades for the treatment of NAFLD, but the reported results are inconclusive. In this way, international guidelines are been published on the management of patients with NAFLD and its related research agenda. However, many questions remain open. This Special Issue aims to become an overview about the currently available knowledge and recent findings regarding NAFLD therapies. I am honored to invite my distinguished colleagues to contribute with reviews and research articles that will stimulate the continuing efforts to better define the therapeutic management of NAFLD in clinical practice and to define the next five years of perspectives.

Dr. Ludovico Abenavoli
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. Pharmaceuticals 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 2900 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

  • nonalcoholic fatty liver disease
  • therapies
  • new treatment
  • insulin resistance
  • liver fibrosis
  • metabolism
  • diet

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Published Papers (2 papers)

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Review

19 pages, 657 KiB  
Review
Antidiabetic Drugs in NAFLD: The Accomplishment of Two Goals at Once?
by Matteo Tacelli, Ciro Celsa, Bianca Magro, Aurora Giannetti, Grazia Pennisi, Federica Spatola and Salvatore Petta
Pharmaceuticals 2018, 11(4), 121; https://doi.org/10.3390/ph11040121 - 8 Nov 2018
Cited by 41 | Viewed by 6861
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in Western countries, accounting for 20–30% of general population and reaching a prevalence of 55% in patients with type 2 diabetes mellitus (T2DM). Insulin resistance plays a key role [...] Read more.
Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease in Western countries, accounting for 20–30% of general population and reaching a prevalence of 55% in patients with type 2 diabetes mellitus (T2DM). Insulin resistance plays a key role in pathogenic mechanisms of NAFLD. Many drugs have been tested but no medications have yet been approved. Antidiabetic drugs could have a role in the progression reduction of the disease. The aim of this review is to summarize evidence on efficacy and safety of antidiabetic drugs in patients with NAFLD. Metformin, a biguanide, is the most frequently used drug in the treatment of T2DM. To date 15 randomized controlled trials (RCTs) and four meta-analysis on the use of metformin in NAFLD are available. No significant improvement in histological liver fibrosis was shown, but it can be useful in the treatment of co-factors of NAFLD, like body weight, transaminase or cholesterol levels, and HbA1c levels. A possible protective role in various types of cancer has been reported for Metformin. Thiazolidinediones modulate insulin sensitivity by the activation of PPAR-γ. The RCTs and the meta-analysis available about the role of these drugs in NAFLD show an improvement in ballooning, lobular inflammation, and perhaps fibrosis, but some side effects, in particular cardiovascular, were showed. GLP-1 analogues stimulate insulin secretion by pancreatic beta cell and inhibit glucagon release; Liraglutide is the most used drug in this class and significantly improves steatosis, hepatocyte ballooning and transaminase levels. Scanty data about the role of DPP-4 and SGLT inhibitors were published. No data about insulin effects on NAFLD are available but it was showed a possible association between insulin use and the development of solid neoplasms, in particular HCC. In conclusion, antidiabetic drugs seem to be promising drugs, because they are able to treat both NAFLD manifestations and diabetes, preventing worsening of hepatic damage, but data are still conflicting. All antidiabetic drugs can be safely used in patients with compensated cirrhosis, while insulin is the preferred drug in decompensated Child C cirrhosis. Full article
(This article belongs to the Special Issue New Advances in the Treatment of Nonalcoholic Fatty Liver Disease)
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10 pages, 232 KiB  
Review
Obeticholic Acid: A New Era in the Treatment of Nonalcoholic Fatty Liver Disease
by Ludovico Abenavoli, Tetyana Falalyeyeva, Luigi Boccuto, Olena Tsyryuk and Nazarii Kobyliak
Pharmaceuticals 2018, 11(4), 104; https://doi.org/10.3390/ph11040104 - 11 Oct 2018
Cited by 55 | Viewed by 8165
Abstract
The main treatments for patients with nonalcoholic fatty liver disease (NAFLD) are currently based on lifestyle changes, including ponderal decrease and dietary management. However, a subgroup of patients with nonalcoholic steatohepatitis (NASH), who are unable to modify their lifestyle successfully, may benefit from [...] Read more.
The main treatments for patients with nonalcoholic fatty liver disease (NAFLD) are currently based on lifestyle changes, including ponderal decrease and dietary management. However, a subgroup of patients with nonalcoholic steatohepatitis (NASH), who are unable to modify their lifestyle successfully, may benefit from pharmaceutical support. Several drugs targeting pathogenic mechanisms of NAFLD have been evaluated in clinical trials for the treatment of NASH. Farnesoid X receptor (FXR) is a nuclear key regulator controlling several processes of the hepatic metabolism. NAFLD has been proven to be associated with abnormal FXR activity. Obeticholic acid (OCA) is a first-in-class selective FXR agonist with anticholestatic and hepato-protective properties. Currently, OCA is registered for the treatment of primary biliary cholangitis. However, promising effects of OCA on NASH and its metabolic features have been reported in several studies. Full article
(This article belongs to the Special Issue New Advances in the Treatment of Nonalcoholic Fatty Liver Disease)
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