Targeting the ileal bile salt transporter in the treatment of non-alcoholic fatty liver disease

Excerpt

Non-alcoholic fatty liver disease (NAFLD) is the liver component of the metabolic syndrome. The disease mainly but not exclusively develops in people who are overweight or obese and in patients with type 2 diabetes. In Western society, NAFLD is highly prevalent and is gaining importance among people in Latin America and Asia [1]. NAFLD can give rise to non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. The hypercaloric Western style diet, rich in fructose and trans-fats, is a main cause of the disease, particularly in patients with genetic susceptibility such as carriers of the PNPLA3 polymorphism [2]. The majority of patients with NASH have insulin resistance suggesting that this plays a role in the pathophysiology of the disease. Although changes in lifestyle such as increased mobility and dietary adaptations are key therapeutic interventions in patients with NASH, caretakers of these patients know that adherence to these lifestyle changes is difficult in the long run. Therefore, effective drugs are needed to treat patients with NASH and prevent progression of the disease. …