NASH is increasing with the current obesity pandemic. Prof. Robert Chilton (San Antonio - USA) reminds us that the current best practices to tackle the burden of this multi-system disease are currently lifestyle interventions
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.
Currently, there are no Food and Drug Administration (FDA)-approved or European Medicines Agency (EMA)-approved therapies for NASH and only lifestyles interventions are recommended for the treatment of NAFLD. Prof Zelber-Sagi (Haifa, Israel) reviews best practices for lifestyle interventions in patients with NAFLD. She warns us against ultra-processed foods and drinks, that are so common in the Western world. She also highlights the benefits of the Mediterranean diet and physical activity.
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.
NAFLD places a substantial burden on healthcare systems and receives little attention from public health authorities. Ambitious measures are needed to improve preparedness globally. Prof Lazarus, Spain, discusses how to establish care pathways tailored to meet patients needs but also that optimally use existing resources. Modifiable risks factors are particularly important in a comprehensive strategy.
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 Schattenberg, Germany, reviews how NASH impacts quality of life. He presents the mechanisms underlying metabolic comorbidities in NASH and discusses the relevant NASH phenotypes.
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.
In this opening talk of the 1st PanNASH webinar, Prof. Sven Francque (Belgium), one of the PanNASH editors, explains how NASH, the number-one liver disease, is part of a multisystem disease. He also sheds light on the etiology of this disease, its epidemiology, symptoms and consequences.
There is a need for new biomarkers that allow the detection and quantification of liver diseases supported on the measurement of fat, iron, fibrosis, inflammation. Dr Romero-Gomez presents a state-of-the-art video on imaging biomarkers with the pros and cons for each technology. For daily practice, he also suggests a diagnosis algorithm