Journal
SEMINARS IN LIVER DISEASE
Volume 28, Issue 4, Pages 360-369Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0028-1091980
Keywords
Bim; c-jun N-terminal kinase; oleic acid; palmitic acid; hepatocyte injury
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Funding
- NIDDK NIH HHS [DK41876, R37 DK041876-21, R37 DK041876, R01 DK041876] Funding Source: Medline
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Nonalcoholic fatty liver disease (NAFLD) is characterized by insulin resistance, which results in elevated serum concentration of free fatty acids (FFAs). Circulating FFAs provide the substrate for triacylglycerol formation in the liver, and may also be directly cytotoxic. Hepatocyte apoptosis is a key histologic feature of NAFLD, and correlates with progressive inflammation and fibrosis. The molecular pathways leading to hepatocyte apoptosis are not fully defined; however, recent studies suggest that FFA-induced apoptosis contributes to the pathogenesis of nonalcoholic steatohepatitis. FFAs directly engage the core apoptotic machinery by activating the proapoptotic protein Bax, in a c-jun N-terminal kinase-dependent manner. FFAs also activate the lysosomal pathway of cell death and regulate death receptor gene expression. The role of ER stress and oxidative stress in the pathogenesis of nonalcoholic steatohepatitis has also been described. Understanding the molecular mediators of liver injury should promote development of mechanism-based therapeutic interventions.
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