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Post Info TOPIC: NAFLD - NASH


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RE: NAFLD - NASH
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There is a lot of new information being reported in the medical journals on Non-Alcohol Fatty Liver Disease and I wish to start a log in my journal to keep track of my research through the medical journals. There may be information here to help prevent the disease, and also to help reverse the disease. Other people are welcome to contribute to this " work in progress".

Avocado was the subject of some research and I was surprised that some scientists had done a review in 2015 of foods that help with NAFLD, and had this to say in the abstract: " This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/ fish oil, coffee, nuts, tea, red wine, avocado and olive oil. Furthermore, it summarises results from animal and human trials and highlights potential areas for future research. "
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588084/)

Choline is showing up in many publications to help and I came across a web site by Bill Sardi that gets right into the nuts and bolts and has abundant references back to 1934.
" Choline is not the only natural antidote

Seven natural molecules that are reported to help control fatty deposits in the liver and blood circulation are choline, inositol, betaine, methionine, rice bran IP6, garlic (allicin) and resveratrol. [Biochemistry Journal April 1951; Anticancer Research 1999; Lipids Health & Disease 2010; World Journal Hepatology April 2014] All are widely available as dietary supplements."
http://knowledgeofhealth.com/how-simple-dietary-supplement-can-quell-modern -diabesity-epidemic/ )

There have been some reports of the TMAO being responsible for atheroclerosis and since it is a byproduct of choline metabolism there is the suspicion that choline could increase this malady. Resveratrol is a TMAO inhibitor and this publication states that one mechanism by which the resveratrol inhibits the TMAO is by altering the bacteria in the gut: " Resveratrol Attenuates Trimethylamine-N-Oxide (TMAO)-Induced Atherosclerosis by Regulating TMAO Synthesis and Bile Acid Metabolism via Remodeling of the Gut Microbiota."
https://www.ncbi.nlm.nih.gov/pubmed/27048804)

Here is a link to a report showing that the TMAO prevents atherosclerosis
http://www.sciencedirect.com/science/article/pii/S0021915015301921)

I reviewed several publications for evidence that resveratrol helps with NAFLD and found evidence of very mild positive effects.

I found a meta-analysis from 2013 about the effectiveness of probiotics on NAFLD: 
" CONCLUSION:
Probiotic therapies can reduce liver aminotransferases, total-cholesterol, TNF- and improve insulin resistance in NAFLD patients. Modulation of the gut microbiota represents a new treatment for NAFLD "
https://www.ncbi.nlm.nih.gov/pubmed/24187469)

" Found this comment of interest: " Protracted exposure to TNF- has been shown to generate oxidative/apoptotic stress that overwhelms antioxidant/antiapoptotic defenses, leading to non-alcoholic steatohepatitis (NASH). Studies in humans with NASH demonstrate that the relative risk for the development of steatohepatitis correlates with increases in TNF- or decreases in adiponectin. "

I do not remember Dr. Gundry discussing the fatty liver disease epidemic, but it looks like reducing the TNF- by reducing the lectins will also improve fatty liver disease problems. 

" Fatty liver disease (FLD) refers to a broad spectrum of conditions characterized simply by fat accumulation within hepatocytes. It affects an estimated 70% of obese individuals and 30% of the general populace. Based on MRI, prevalence is approximately 1/2 of Hispanic Americans, 1/3 of whites, and 1/4 of African Americans. It is the most common cause of chronic liver disease and subsequent cryptogenic cirrhosis, and is known to contribute to the progression of other liver diseases such as Hepatitis C and hepatocellular carcinoma. " "

CIRRHOSIS AND CIRRHOSIS REVERSAL
I did some research on cirrhosis reversal and was surprised there is evidence, in pubmed, of compounds that help with reversal of cirrhosis. One was a animal study of curcumin, and the other was a review from March, 2017 that reviewed most of the research results up to that date. I will include some excerpts that stood out to me and then links to the pubmed publications.

" Curcumin was effective in preventing and reversing cirrhosis, probably by its ability of reducing TGF-beta expression. "
https://www.ncbi.nlm.nih.gov/pubmed/18705752)

" In the past, liver cirrhosis was considered an irreversible phenomenon. However, many experimental data have provided evidence of the reversibility of liver fibrosis. Moreover, multiple clinical studies have also shown regression of fibrosis and reversal of cirrhosis on repeated biopsy samples. "

" In this article, we present the underlying mechanisms of fibrosis, current experimental and clinical evidence of the reversibility of liver fibrosis/cirrhosis, and new agents with therapeutic potential for liver fibrosis. "

" Chronic inflammation is the main cause of hepatic fibrogenesis and it was found to be present in the majority of chronic liver diseases such as viral hepatitis, toxic liver injury, alcoholic hepatitis, non-alcoholic steatohepatitis (NASH), and autoimmune liver diseases [5] "

" In fibrotic NASH, progression is intimately linked with insulin resistance/type 2 diabetes as well as lipotoxic hepatocyte death and intestinal dysbiosis, providing rational targets for both anti-inflammatory and antifibrotic therapy. Therapeutic strategies include reducing oxidative stress, improving insulin signaling, activating the farnesoid X receptor (e.g., with obeticholic acid), fibrosis-targeted inhibitors of hedgehog signaling, combined PPAR-/ agonists, or manipulation of altered gut microbiota using probiotics or microbiota transfer [120]. Although oxidative stress is an important cofactor in fibrosis, the use of antioxidants has proved disappointing. "
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339475/)


A publication from June, 2017, World Journal of Hepatology :
" The most applied medical plants in herbal treatments were selected and their mechanism of action on liver diseases and on immun system were searched to establish the Table Table3.3. Flavonoid derivatives such as silybin, silymarin, obtained from milk-thistle [Silybum marianum (L.) Gaertn.] decreased alkaline phosphatase (completely) and gamma-glutamyl transpeptidase (partially) in CCl4 induced liver damage[17]. Moreover, it has been claimed that Silymarine containing preparations are the principal therapeutic of choice in liver diseases caused by oxidative stress. Many studies have proven that plant phyto compound Silymarin has medical applications to cure (alcoholic and non-alcoholic) fatty liver, cirrhosis, ischaemic injury, drug and chemically-induced hepatic toxicity, radiation toxicity, viral and toxic hepatitis by means of its anti-oxidative, anti-lipidperoxidative, anti-fibrotic, anti-inflammatory, liver regenerating and immunomodulating effects. Several studies have identified that continuous usage of Silymarin has significantly proved to increase the survival period of patients with alcohol-caused liver cirrhosis and primary liver cancer[18] (Figure (Figure1).1). Scientific studies also have shown that, both silybin and silymarin normalized immunoregulatory failures by restoration of the cellular thiol status, T-cell activation (CD69), together with a substantial decrease in TNF[18,19]. Effects of the selected herbal medicines on immune and liver were summarized in Figure Figure1.1. Another study demonstrated that an edible plant Artichoke (Cynara scolymus L.) prevented CCl4 and oxidative stress-induced hepatotoxicity and it protected the liver[20]. Inulin, obtained from artichoke, stimulates components of the IS[21]. The extract of the rhizome Turmeric (Curcuma longa L.), which has hepatoprotective plant, amplified both Th1 (IL-2 and IFN gamma) and Th2 (IL-10) cytokines signifying its dual immune roles. Polysaccharide fraction of this rhizome showed potent immunostimulatory action in the direction of proliferation of splenocytes cell number and IL-10 secretion. Polysaccharides of the plant extract might be causative of these proliferative and cytokine release assets in murine splenocytes. In different studies have been shown that the cytokine productions (TGF-, TNF-, GM-CSF, IL-1, IL-5, IL-6, IL-8, IL-10, IL-13, etc.) have been modulated by polysaccharide-enriched fractions[18,22-24]. Fennel (Foeniculum vulgare Mill.) and liquorice (Glycyrrhiza glabra L.) have also shown immunomodulatory and hepatoprotective effects[18,25-27]. "
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474722/)

Here is a link to the table #3, mentioned in the quote above:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474722/table/T3/)

Inulin is a prebiotic found in many health formulas and there is well documented evidence that the inulin is very helpful for a variety of health problems. I will include a link to the reference in the above quote that addressed inulin, from 2005:
https://www.ncbi.nlm.nih.gov/pubmed/15960982)

I also took note of the emphasis on the substantial decrease in TNF by silybin and silymarin, the major active compound in milk thistle. Suppressing TNF is the main goal of a variety of biologics.



__________________

angie

F, Age 49, Dx 1998, GT2B. Pre-treatment VL 550,000 IU/ml, ALT 37, AST 28. Rx 12 weeks of Epclusa. SOT Jul 2, 2018 to Sept 24, 2018. .

Tig


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Here is a section for discussion of NAFLD (Non Alcoholic Fatty Liver Disease) and NASH (Non Alcoholic Steato-Hepatitis). Please feel free to add any information pertaining to these liver diseases here.

Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in your liver. Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. If you have NASH, you have inflammation and liver cell damage, along with fat in your liver.



__________________

Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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