Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in human history, with probable ties to countless deaths through the ages. Although NAFLD has always existed, it wasn’t clinically characterized until the 1980s. In the almost 40 years of medical and scientific knowledge of NAFLD, it has grown to a prevalence that affects almost two billion people globally – that’s nearly a quarter of the earth’s human population.
We often hear about obesity and the health problems it causes, but there is a disconnect in knowing that NAFLD is a result from obesity. As such, NAFLD is largely unknown to the general population, policymakers and even the global public health community. Despite the already staggering number, NAFLD is projected to grow in the coming decades, which carries more than just personal health related consequences.
To better understand NAFLD, it is important to become familiar with the progressive stages of liver damage. NAFLD occurs when excess fat accumulates in liver cells in people who consume little or no alcohol. This effect is derived from a diet rich in animal fats and with low to nonexistent levels of physical activities. Additionally, NAFLD is associated with various other metabolic risk factors, such as obesity and diabetes.
We have heard the simple fix to all this is just diet and exercise. Unfortunately, the trends and data clearly show that not everyone in society has the means nor the opportunity to accomplish this. As a result, many people are trapped in this deadly situation.
A major factor to be aware of is that the early stages of NAFLD are asymptomatic and may not be taken as serious as it should. As the disease progresses, there is a tipping point in which in many patients with NAFLD develop non-alcoholic steatohepatitis (NASH). This is when a liver has excessive fat buildup and is damaged by histological inflammation. As a result, the liver starts to undergo scarring (fibrosis) as it tries to repair itself. If left unchecked by constant inflammation and increasing fat buildup, eventually leads to extensive liver fibrosis.
The last stage in this disease is cirrhosis, which is very severe liver fibrosis. Cirrhosis is where the liver is severely scarred and permanently damaged. There is no treatment that can cure cirrhosis. If possible, treating the underlying cause of cirrhosis may keep cirrhosis from getting worse and help prevent overall liver failure. At that point, the only remedy is a full liver transplant.
Fatty liver disease is diagnosed after blood tests show elevated liver enzymes. For example, the doctor may order the alanine aminotransferase test (ALT) and aspartate aminotransferase test (AST) to check liver enzymes. These tests might be recommended if there are signs or symptoms of liver disease, or they might be ordered as part of routine blood work. Elevated liver enzymes are a sign of liver inflammation. If those results are significant enough, then it is time to make a change. At this point early on, the condition is reversible with medications and a change in diet with increased activity.
Currently, no medications have been FDA approved to treat NAFLD. More research is needed to develop and test medications to treat this condition. In general, specific lifestyle changes can help reverse fatty liver disease. For example, patients would be advised to: (1) limit or avoid alcohol, (2) take steps to lose weight, (3) make changes to your diet and (4) get at least 30 minutes of exercise most days of the week.
PrimeGen is working on a cell-based solution to naturally treat liver disease. The stemXcell platform allows for the rapid identification of inflammatory cytokines and proteins responsible for immune and inflammatory response. The identified cytokines are used with MSCs to modulate and naturally down regulate cells responsible for an overactive inflammatory immune response. Mesenchymal stem cells have attracted much attention for their ability to regulate inflammatory processes. Their therapeutic potential is currently being investigated by PrimeGen for multiple diseases. With stemXcell™, PrimeGen can develop targeted therapies for multiple inflammatory diseases.
- Lazarus, J.V., et al. NAFLD — sounding the alarm on a silent epidemic. Nat Rev Gastroenterol Hepatol 17, 377–379 (2020) https://doi.org/10.1038/s41575-020-0315-7