Dr. Kwanten (Belgium) discusses the pathophysiological role of intrahepatic vasculature in non-alcoholic fatty liver disease (NAFLD). He mentions that portal hypertension is present in patients with NAFLD and can be evident in the early stages which is caused by intrahepatic vascular alterations. Further, he explores the different types of drugs that will help change the course of the disease.
Dr. Scott Friedman talks about HCC pathogenesis in NASH and the impact of fibrosis. This video is adapted from a lecture Dr. Scott Friedman gave at the Paris NASH meeting and illustrates the highlights of that topic in this video.
Dr. Kris Kowdley explains the natural history and clinical outcomes in adults with non -alcoholic fatty liver disease (NAFLD) with lessons from cohort studies and placebo arms of trials. The take home points are that the natural history of NAFLD is variable
Prof. Luisa Vonghia (Belgium) explores the role of fatty liver disease and metabolic comorbidities in the progression of chronic liver diseases. The key points addressed in this video are that co-existent fatty liver and related metabolic factors, including obesity and diabetes mellitus, exacerbate liver injury in patients with another chronic liver disease(s).
Dr. Nicolas Lanthier (Belgium) reviews the interaction between the gut microbiota and PPARs in NAFLD. He discusses the microbiota and its link to NAFLD and IR, where he explains the key role of the gut microbes in the metabolism of their host and highlights how liver becomes the first organ to be exposed to gut changes.
Dr. Moritz Peiseler (La Charité - Germany), discusses new scientific insights into the role of inflammation in NAFLD / NASH. He presents the spectrum of NAFLD and explains how inflammation can drive all the progressive stages of NAFLD. He also reviews hepatocellular carcinoma (HCC) risks and presents several studies and evolving treatments for NASH.
Prof. Pierre-E.Rautou (France) discusses the effects of Liver Sinusoidal endothelial cell (LSEC) capillarization in patients with NASH. He also reviews the occurrences of LSEC capillarization at the early stages of NASH and its contribution to NASH progression by favoring inflammation and liver fibrosis. For the clinicians, he demonstrates a 24 week study of patients with NASH, exposed placebo and lanifibranor treatments strategies to determine LSEC changes.
Prof. Manuel Romero-Gomez discusses the course of liver histology and its impact on mortality and morbidity in patients with NAFLD and NASH. He clarifies how fibrosis determines the prognosis of NAFLD and is the main therapeutic target. The importance of steatosis is also discussed both at the early phase and advanced phase. Finally he reviews the association with HCC and CV risks.
NAFLD is strongly associated with obesity and metabolic disease. Obesity has clinical implications that extend beyond the liver. It is associated with insulin resistance which plays an important role in NASH. Agents with combined PPAR agonism may hold significant potential in this regard.
Prof Bugianesi, Italy, reviews a burning issue: hepatocellular carcinoma (HCC) in patients with NAFLD/ NASH. She reviews the epidemiology globally and impact on liver transplant. There are multiple risks factors for HCC in NASH patients such as obesity, type 2 diabetes (T2D), and the metabolic syndrome in general. For clinicians, she presents the main studies, the profiles of the patients particularly at risk and risk stratifications strategies.
Prof Sanyal, USA, reminds us that NAFLD is the most common liver disease and reviews the comorbidities associated with NAFLD, and particularly the association with cardiovascular disease.
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