Journal
JOURNAL OF HEPATOLOGY
Volume 68, Issue 2, Pages 268-279Publisher
ELSEVIER
DOI: 10.1016/j.jhep.2017.09.003
Keywords
Non-alcoholic fatty liver disease; Steatohepatitis; Genetic variation; Epigenetics; PNPLA3
Categories
Funding
- Robert W. Storr Bequest to the Sydney Medical Foundation, University of Sydney
- National Health and Medical Research Council of Australia (NHMRC) [1053206, APP1107178, APP1108422]
- Associazione Italiana Ricerca sul Cancro, myFIRST Grant AIRC [16888]
- Molecular Medicine Grant Fondazione IRCCS Ca' Granda
- INGM, Ricerca Corrente Fondazione Ca' Granda IRCCS Policlinico of Milan
- Swedish Research Council (Vetenskapsradet) [254439006, K2013-54X-11285-19]
- Swedish Heart Lung Foundation [244439007]
- Swedish federal government [76290]
- Sahlgrenska University Hospital ALF [ALFGBG-428911]
- Novonordisk Foundation Grant for Excellence in Endocrinology [244439012]
- Swedish Diabetes Foundation [DIA 2014-052]
- Associazione Malattie Metaboliche del Fegato ONLUS
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Non-alcoholic fatty liver disease (NAFLD) is now recognised as the most common liver disease worldwide. It encompasses a broad spectrum of conditions, from simple steatosis, through non-alcoholic steatohepatitis, to fibrosis and ultimately cirrhosis and hepatocellular carcinoma. A hallmark of NAFLD is the substantial inter-patient variation in disease progression. NAFLD is considered a complex disease trait such that interactions between the environment and a susceptible polygenic host background determine disease phenotype and influence progression. Recent years have witnessed multiple genome-wide association and large candidate gene studies, which have enriched our understanding of the genetic basis of NAFLD. Notably, the I148M PNPLA3 variant has been identified as the major common genetic determinant of NAFLD. Variants with moderate effect size in TM6SF2, MBOAT7 and GCKR have also been shown to have a significant contribution. The premise for this review is to discuss the status of research into important genetic and epigenetic modifiers of NAFLD progression. The potential to translate the accumulating wealth of genetic data into the design of novel therapeutics and the clinical implementation of diagnostic/prognostic biomarkers will be explored. Finally, personalised medicine and the opportunities for future research and challenges in the immediate post genetics era will be illustrated and discussed. (C) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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