OSAS-related inflammatory mechanisms of liver injury in nonalcoholic fatty liver disease.
Elena PaschettaPaola BelciAnna AlisiDaniela LiccardoRenato CutreraGiovanni MussoValerio NobiliPublished in: Mediators of inflammation (2015)
Obstructive sleep apnoea syndrome (OSAS) is a common sleep disorder, affecting over 4% of the general population, and is associated with metabolic syndrome and cardiovascular disease, independent of obesity and traditional risk factors. OSAS has been recently connected to nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease in the world, which can be found in 30% of the general adult population. Several studies suggest that the chronic intermittent hypoxia (CIH) of OSAS patients may per se trigger liver injury, inflammation, and fibrogenesis, promoting NAFLD development and the progression from steatosis to steatohepatitis, cirrhosis, and hepatocellular carcinoma. In NAFLD patients, liver disease may be caused by hypoxia both indirectly by promoting inflammation and insulin resistance and directly by enhancing proinflammatory cytokine production and metabolic dysregulation in liver cells. In this review, we focus on molecular mechanisms linking OSAS to NAFLD, including hypoxia inducible factor (HIF), nuclear factor kappa B (NF-κB), YKL-40, unfolded protein response, and hypoxic adipose tissue inflammation, which all could provide novel potential therapeutic approaches for the management of NAFLD patients with OSAS.
Keyphrases
- liver injury
- insulin resistance
- drug induced
- nuclear factor
- metabolic syndrome
- adipose tissue
- oxidative stress
- end stage renal disease
- cardiovascular disease
- risk factors
- ejection fraction
- chronic kidney disease
- newly diagnosed
- toll like receptor
- prognostic factors
- skeletal muscle
- peritoneal dialysis
- signaling pathway
- physical activity
- immune response
- depressive symptoms
- polycystic ovary syndrome
- coronary artery disease
- small molecule
- high intensity
- cell proliferation
- weight loss
- liver fibrosis
- patient reported outcomes
- inflammatory response
- amino acid