Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2017; 23(36): 6549-6570
Published online Sep 28, 2017. doi: 10.3748/wjg.v23.i36.6549
Treatment options for alcoholic and non-alcoholic fatty liver disease: A review
Sukhpreet Singh, Natalia A Osna, Kusum K Kharbanda
Sukhpreet Singh, Natalia A Osna, Kusum K Kharbanda, Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE 68105, United States
Natalia A Osna, Kusum K Kharbanda, Department of Internal Medicine, Nebraska Medical Center, Omaha, NE 68198, United States
Kusum K Kharbanda, Department of Biochemistry and Molecular Biology, Nebraska Medical Center, Omaha, NE 68198, United States
Author contributions: All authors equally contributed to this paper with conception, literature review, drafting and critical revision, editing, and approval of the final version.
Supported by Merit Review grants BX001155 from the Department of Veterans Affairs, Office of Research and Development (Biomedical Laboratory Research and Development) to Kharbanda KK.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kusum K Kharbanda, PhD, Professor, Veterans Affairs Nebraska-Western Iowa Health Care System, Research Service (151), 4101 Woolworth Avenue, Omaha, NE 68105, United States. kkharbanda@unmc.edu
Telephone: +1-402-9953752 Fax: +1-402-9954600
Received: May 13, 2017
Peer-review started: May 16, 2017
First decision: June 22, 2017
Revised: July 25, 2017
Accepted: September 5, 2017
Article in press: September 5, 2017
Published online: September 28, 2017
Abstract

Alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) are serious health problems worldwide. These two diseases have similar pathological spectra, ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma. Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver (simple steatosis), a small percentage develops progressive liver disease. Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available. The treatment for ALD remains as it was 50 years ago: abstinence, nutritional support and corticosteroids (or pentoxifylline as an alternative if steroids are contraindicated). As for NAFLD, the treatment modality is mainly directed toward weight loss and co-morbidity management. Therefore, new pathophysiology directed therapies are urgently needed. However, the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy. Hence, a combination therapy towards multiple targets would eventually be required. In this review, we delineate the treatment options in ALD and NAFLD, including various new targeted therapies that are currently under investigation. We hope that soon we will be having an effective multi-therapeutic regimen for each disease.

Keywords: Alcoholic liver disease, Non-alcoholic fatty liver disease, Treatment options, Glucocorticoids, Liver transplantation

Core tip: Alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) are serious health problems worldwide. Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available. In this review, we delineate the treatment options in ALD and NAFLD, including various new targeted therapies that are currently under investigation.