%0 Journal Article
%T Obesity, fatty liver and the putative role of the sympathetic nervous system
%A Radhika K Jadavji
%J Calicut Medical Journal
%D 2008
%I 
%X Obesity is a worldwide epidemic and afrequent finding in non-alcoholic fatty liver disease(NAFLD) amongst other diseases that encompass themetabolic syndrome. NAFLD covers a spectrum ofdisease ranging from fatty liver through toinflammation in NASH followed by cirrhosis and endstage HCC. The ¡°two hit¡± hypothesis describe the 1sthit as representative of hepatic steatosis and the 2nd¡®hit¡¯ thought to be related to ROS-mediated oxidativedamage and inflammatory processes with an overallshift away toward free fatty acid synthesis. Theaetiological association of insulin resistance with fattyliver has led to the suggestion that it is in some wayresponsible for the entire spectrum of NAFLD. Insulinstimulates the SNS which correlates well with theenhanced SNS activity seen in obesity and NAFLD.SNS activation is known to promote hepaticfibrogenesis following liver damage and subsequentlyimpair regenerative hepatocytes proliferation.Therefore, novel therapies with the aim of suppressingthe SNS present an attractive strategy to alleviatechronic liver disease. Supporting evidence comes fromexpansion of the hepatic stem cell compartmentfollowing SNS inhibition and reduction of fibrosis dueto ¡°switching off¡± fibrogenic hepatic stellate cells. Inthis review, we highlight the importance of the SNS inthe pathogenesis of chronic liver disease.
%U http://www.calicutmedicaljournal.org/2008/1/e4.pdf