INTRODUÇÃO: A Doença Hepática Gordurosa Não Alcoólica (DHGNA) é atualmente a forma mais comum de doença hepática. Sem fisiopatologia totalmente esclarecida, apresenta-se na forma de esteatose, até formas mais avançadas denominadas Esteatohepatite não alcoólica (EHNA). Citocinas como TNF-, são frequentemente mensuradas em EHNA, diferente da IL-6 e IL-10. MÉTODOS: Pacientes moderadamente obesos (n=80) com histologia apresentando esteatose (n=29) e EHNA (N=51). Níveis de citocinas séricas foram dosadas. O objetivo foi correlacionar a correlação das citocinas com esta população. RESULTADOS: Pacientes diabéticos tendem a ser mais associados com EHNA (52.5% vs 41.4%, P=0.015), sem diferença na idade, gênero ou IMC considerando esteatose. Para a população total, não houve diferenças significantes entre as citocinas, incluindo TNF- e IL-6. Em paciente diabéticos, todas as citocinas tenderam à diminuir na EHNA, especialmente IL-10(P= 0.000). A citocina IL-10 correlacionou-se com o índice HOMA (P=0.000) e outras variáveis de homeostase no diabetes, representando assim, um marcador importante nesta doença. CONCLUSÕES: 1) Em geral, ocorrem mudanças inconsistentes nas citocinas quando comparados os pacientes com esteatose.2) Em contraste, baixa regulação da IL-6 e IL- 10 foram persistentes em pacientes diabéticos com NASH. 3) Hipertensão Arterial não apresentou alteração nessas circunstâncias.4) IL-10 manteve forte correlação com os índices de metabolismo glicêmico. 5) TNF- não pode ser responsabilizado pelo dano hepático progressivo, pois seus valores não aumentaram na EHNA.6) Investigação da IL-10 e outras citocinas contra reguladoras são necessárias neste contexto e merecem mais estudos. / Background: Fatty liver disease is a problem of obesity in the morbid modality and even more so in nonbariatric candidates, who rely on clinical treatment only. TNF- has been frequently measured in steatohepatitis (NASH) with or without diabetes, but less in known about IL-6 and IL-10. Methods: Moderately obese patients (n=80) with histologically proven Steatosis (n=29) and NASH (n=51) were recruited. Serum levels of cytokines were documented along with clinical information. The aim was to identify the correlates of such biomolecules in a stable population.Results: Diabetes tended to be more associated with NASH (52.5% vs 41.4%, P=0.015), with no difference of age, gender or BMI regarding steatosis . For the entire population cytokine changes were not significant., including TNF- and IL-6. In diabetics only, all markers tended to diminish with NASH, especially IL-10 (P= 0.000). IL-10 correlated with HOMA index (P=0.000) and other variables of glucose homeostasis in diabetes, thus representing a major marker of the disease.Conclusions: 1)Generally inconsistent changes in pro- and antiinflammatory cytokines occurred when NASH was globally compared to steatosis. 2) In contrast, downregulation of IL-6 and IL-10 was perceived in diabetics with NASH. 3) Arterial hypertension did not play a role in these circumstances. 4) IL-10 maintained strong correlations with glucose metabolism indices. 5) TNF- could not be incriminated for progressive liver damage, as values failed to increase in NASH. 6) Investigations of IL-10 and other counterregulatory cytokines are lacking in this context and deserve further studies.

Obesity can lead to a range of health problems including type 2 diabetes (T2DM), cardiovascular disease and non-alcoholic fatty liver disease (NAFLD), and causes an estimated 2.8 million deaths annually (2016). It is a growing epidemic affecting over 600 million people worldwide (in 2014), with 26.8% of the adult population in England alone being obese, an increase of 10% in the last decade, and 62.9% overweight or obese. This trend is predicted to continue, and is attributed to an increasingly sedentary lifestyle, coupled with a high calorie “western diet”, which is estimated to cost >£25billion/year in the UK (2015), which is predicted to rise to £49.9 billion by 2050. It is clear that both sex and genetics affect the extent to which individuals exposed to a high fat diet develop adiposity and its associated morbidities, although the mechanisms underlying these differences are not well understood. Here we explore this aetiology, focusing on poly(A)-binding protein 4 (PABP4), an RNA-binding protein in which polymorphisms associated with altered cholesterol levels and cardiovascular disease risk were identified in human GWAS studies. To this end, I take advantage of an unpublished Pabp4 knock-out mouse, maintained on either normal (ND) or high fat diet (HFD), to explore the role of PABP4 in determining the response to high fat diet. PABP4 is a poorly characterised member of the PABP family, which are multifunctional central regulators of global and mRNA-specific translation, and stability. In cell lines, PABP4 is predominantly cytoplasmic, consistent with such functions. However, analogously to PABP1, the prototypical PABP family member, PABP4 is relocalised to stress granules or the nucleus in response to specific cellular stresses and/or viral infections, suggesting a role in altering gene expression programs in responses to changing cellular conditions. Whilst the expression pattern of PABP4 within tissues has not been previously characterised, western blotting of adult mouse tissues revealed that PABP4 is highly expressed in tissues relevant to obesity, T2DM and NAFLD, such as adipose, pancreas, liver and muscle, consistent with the idea that it may play a role in regulating gene expression programs in response to HFD. Immunohistochemistry of tissue sections provided additional insight, revealing a distinct cellular distribution of PABP4 in some tissues, when compared to the well characterised PABP1. Birth weight and post-birth growth can affect adult metabolism. In particular, low birth weight and catch-up growth, characterised by preferentially putting down adipose over lean mass, increases the risk of metabolic conditions in adulthood, such as obesity, T2DM and cardiovascular disease. Therefore, Pabp4-/- and wildtype mice were weighed at birth and daily until weaning. Interestingly this revealed that Pabp4-/- mice have a reduced weight at birth that is exacerbated to weaning (21days (P21)) (5.7% and 18.3% reductions respectively). This analysis also uncovered a reduced survival to weaning, with both male and female Pabp4-/- mice being present at sub-Mendelian ratios by P21 (p=0.0056). Whilst most death occurred neonatally, Pabp4-/- mice showed an increased rate of attrition until weaning, preceded in some cases by an arrest of weight gain. Weight gain was also tracked from 4 weeks to 12 weeks of age on normal diet showing that Pabp4-/- mice had reduced weight into adulthood (12% reduction at 12wks). Analysis of weight gain by sex uncovered a sexually dimorphic effect of Pabp4-deficiency, with female, but not male, Pabp4-/- mice remaining reduced in weight compared to wildtype after 8 weeks on ND (13.4% reduction in female weight). Body composition analysis showed that fat mass was equivalent to wildtype at 12 weeks of age in both sexes but that female Pabp4-/- mice had a 14.3% reduction in lean mass. Neither the catch-up growth in males nor the reduced lean mass in females was sufficient to result in a change in glucose homeostasis. As the risk of developing metabolic disorders in adult life is a consequence of both genetic and environmental factors, such as diet, Pabp4-/- were placed on a HFD at 4 weeks of age for 8 weeks. HFD models the ‘western’ diet, and has been shown to induce obesity, insulin resistance and glucose intolerance in wildtype mice. Whereas Pabp4-/- mice were only distinguishable from wild-type in terms of female lean mass on normal diet, pronounced sexually dimorphic differences were observed in HFD fed mice. Male Pabp4-/- mice appeared to be partially protected from the negative effects of an 8 week HFD regimen, with a 44% decrease in adipose mass gain compared to wildtype despite equal lean mass. Pabp4-/- male mice also had significantly reduced ectopic lipid stores, with an 81% decrease in hepatic triglyceride concentration compared to wildtype, meaning that NAFLD has not developed. Furthermore, Pabp4- /- male mice did not develop hyperinsulinemia on HFD and retained insulin sensitisation (assessed via glucose tolerance test (GTT) and insulin tolerance test (ITT)), although they displayed wildtype-like elevated plasma glucose concentrations (compared to ND). Western blotting had detected high PABP4 levels in the pancreas, indicating a possible pancreatic origin of these alterations. However, immunofluorescence revealed that PABP4 was confined to the exocrine portion of the pancreas, and was undetectable in the insulin producing pancreatic beta cells, suggesting this phenotype may not be beta cell in origin. This is consistent with the fact that the Pabp4-/- male mice retained an appropriate glucose-induced burst of insulin secretion, and therefore insulin production appears unimpaired. Thus, the primary defect may reside in the exocrine pancreas, which aids digestion, or in other key metabolism related tissues (e.g. muscle, liver, adipose and brain), or a combination thereof. In HFD fed wildtype mice, insulin resistance is caused by increased adiposity and ectopic lipid depots, which blunt insulin stimulated signalling cascades, meaning that the normal responses to insulin (e.g. cellular up take of glucose in muscle and arrested glucose production in liver, to decrease plasma glucose concentrations), are impaired. Therefore, the absence of insulin resistance in HFD fed Pabp4-/- male mice may be a consequence of the reduced increase in adipose mass and ectopic lipid deposits detected in these mice, and their consequent lack of inhibition on insulin signalling pathways. The reduced adiposity was not a result of reduced food intake or dietary fat absorption as male Pabp4-/- mice did not eat less nor exhibit apparent steatorrhea (fatty stools). These results highlight that the Pabp4-/- male mice appear to have an alteration in energy use/storage, and the investigation of this will form the basis of future work. When fed HFD, female Pabp4-/- mice revealed a divergent phenotype to that of wildtype female mice and Pabp4-/- male mice. HFD fed Pabp4-/- female mice showed no difference to HFD-fed wildtype mice in terms of weight, but still exhibited the reduction in lean mass seen on ND, but now with a 22.8% increase in volume of adipose tissue. Together, this means that HFD fed Pabp4-/- females have a higher body fat percentage (32.6% compared to 25.9 % for wildtype females). In contrast to the males, there was no difference in terms of hepatic triglycerides in HFD fed Pabp4-/- female mice and they showed greater hyperglycaemia than wildtype (GTT), although like males they retained insulin sensitisation (ITT). These potentially conflicting results in terms of insulin sensitivity and plasma glucose concentrations may result from the alterations in body composition, which can confound results when lean mass is altered and total body weight is used for calculating doses for GTT/ITT. Interestingly, adiponectin, an adipokine normally found in inverse proportion to adipose mass, was increased in plasma from HFD fed Pabp4-/- female mice (21% increase from HFD fed wildtype mice). Whilst surprising given the increase fat mass of Pabp4-/- females, the insulin sensitising properties of adiponectin may help to explain the retained insulin sensitivity detected in the female Pabp4-/- mice. / The finding that HFD revealed metabolic differences in the Pabp4-/- mice lead to the question of whether Pabp4-/- mice have issues adapting to other situations which require modulation of energy storage and glucose homeostasis. One such event is pregnancy, when maternal regulation of insulin resistance is tightly modulated throughout gestation. We therefore characterised the maternal Pabp4-/- environment in late pregnancy (E18.5), when insulin sensitivity decreases to 40-60% lower than pre-pregnancy which results reduced maternal glucose uptake, freeing the glucose up for the rapidly developing foetus. Pregnant Pabp4-/- mice had elevated plasma insulin concentration post fasting (63.7% increase), however glucose homeostasis was wildtype-like, both in terms of plasma glucose and insulin concentrations, throughout a GTT. However, plasma glucose and insulin concentrations in E18.5 Pabp4-/- foetuses were significantly decreased (9% and 44.3% respectively). Pabp4-/- foetuses also had reduced foetal and placental weight/length parameters. This establishes that the differences in weight observed at birth were present by late gestation and secondly, that the reductions in both foetal glucose and insulin concentrations which may contribute to or underlie the reduced growth. It also suggests that the differences seen in adulthood on HFD may be a consequence of metabolic differences present during pregnancy. Taken together, these data support the hypothesis that PABP4 plays a key role in the regulation of mRNAs which are important in growth, post-natal survival and metabolic adaption to high fat diet.

Os enxertos hepáticos com esteatose apresentam risco aumentado para a disfunção e o não funcionamento primário. Entretanto, considerando o permanente desequilíbrio entre a oferta e a demanda de enxertos, justifica-se o uso de fígados esteatóticos com um risco aceitável. O padrão ouro para o diagnóstico do grau da esteatose hepática, na prática clínica, é o exame histológico. Entretanto, no cenário dos transplantes, a estimativa do grau de esteatose do enxerto hepático depende do exame macroscópico. Nesse procedimento a leitura da cor é realizada de forma subjetiva e a força da associação cor-esteatose não é conhecida. Considerando esses aspectos, a presente pesquisa teve como objetivo verificar a associação entre a cor do fígado e a intensidade da esteatose hepática, aferindo a cor do fígado, de forma precisa com um colorímetro e quantificando a esteatose com dois exames considerados de referência. Método: Ratos wistar, machos, foram divididos em quatro grupos de quinze animais. Os animais do grupo controle receberam dieta padrão. Os outros três grupos receberam dieta esteatogênica durante, respectivamente, dois, quatro e seis dias. Os ratos foram submetidos à laparotomia, biópsia hepática (pré e pós-perfusão do fígado) para realizar o exame histológico, colorimetria no padrão RGB (pré e pós-perfusão do fígado), conversão da cor, do padrão RGB, para o padrão CINZA, coleta de sangue para realizar exames laboratoriais e hepatectomia (para determinar o peso relativo do fígado e a extração da gordura). A análise estatística foi realizada com o pacote de software estatístico IBM SPSS Statistics 18, e o valor p < 0.05 foi considerado com significado estatístico. Resultados: Foi observada correlação positiva entre os percentuais de gordura e a intensidade das cores pré perfusão (coeficiente de correlação da cor vermelha 0,874, cor verde 0,747 e cor azul 0,763) e pós-perfusão (coeficiente de correlação da cor vermelha 0,900, cor verde 0,886 e cor azul 0,856). As medias dos valores da colorimetria, pré e pós perfusão, apresentaram diferença estatisticamente significativa (p < 0,001). A acurácia da colorimetria pós perfusão, determinada pela curva ROC, foi de100% na determinação da presença de esteatose, 96,2% para o grau moderado ou intenso e 80,4% para o grau intenso da esteatose. Foi verificada diferença significativa dos valores da colorimetria (p < 0,001) entre as medias dos diversos grupos com exceção entre os grupos concentração de gordura moderada X gordura intensa e entre os grupos graus histológicos da esteatose leve X moderada X intensa. Conclusões: a) A cor do fígado, pré e pós perfusão, apresentou correlação forte com a esteatose, de forma positiva e linear; b) A colorimetria, pré e pós perfusão, apresenta a mesma acurácia na identificação da esteatose c) A colorimetria apresentou acurácia perfeita na identificação da presença da esteatose e tendência para classificar, em um mesmo grupo, a esteatose moderada e intensa. / Hepatic grafts with steatosis are at increased risk for dysfunction and primary non-functioning. However, considering the permanent imbalance between supply and demand of grafts, the use of specially selected livers with steatosis is justified. The gold standard for the diagnosis of hepatic steatosis in clinical practice is histological examination. However, in the transplant scenario, the estimation of the grade of hepatic graft steatosis depends on macroscopic examination. In this procedure the color reading is carried out subjectively and the strength of the association of color-steatosis is not known. Considering these aspects, the present study aimed to verify the association between liver color and liver steatosis intensity, accurately assessing the color of the liver with a colorimeter and quantifying steatosis with two exams considered as reference. Method: Male wistar rats were divided into four groups of fifteen animals. The animals in the control group received a standard diet. The other three groups received a steatogenic diet during, respectively, two, four and six days. Rats were submitted to laparotomy, liver biopsy (pre and post-perfusion of the liver) for conventional histological examination, colorimetry in the RGB pattern (pre and post-perfusion of the liver), color conversion from the RGB standard to the GRAY standard, Blood collection for laboratory tests and hepatectomy (to determine relative liver weight and fat extraction). Statistical analysis was performed with the statistical software package SPSS Statistics 18, and p value <0.05 was considered statistically significant. Results: A positive correlation was observed between fat percentages and preperfusion color intensity (red color correlation coefficient 0.874, green color 0.747 and blue color 0.763) and postperfusion (correlation coefficient of red color 0.900, green color 0.866 and blue color 0.856). The mean values of the colorimetry, pre- and post-perfusion, presented a statistically significant difference (p <0.001). The accuracy of the post-perfusion colorimetry, determined by the ROC curve, was 100% in the determination of the presence of steatosis, 96.2% for the moderate or intense degree and 80.4% for the intense degree of steatosis. There was a significant difference (p <0.001) between the means of the different groups except for the groups of moderate fat X intense fat concentration and between the histological grades groups of mild X intense moderate X steatosis. Conclusions: a) The color of the liver, pre and post perfusion, showed a strong correlation with steatosis, in a positive and linear way; B) Colorimetry, pre- and post-perfusion, shows the same accuracy in the identification of steatosis. C) Colorimetry showed perfect accuracy in the presence of steatosis and a tendency to classify moderate and severe steatosis in the same group.

Non-alcoholic fatty liver disease (NAFLD) results from an unequal uptake/storage and export/oxidation of lipids within the liver and is often a secondary disease to type II diabetes (22). NAFLD causes this imbalance of lipids by altering glucose and lipid metabolism, which corresponds to a decrease in mitochondrial function leading to failure of the liver. One established treatment for type II diabetes and NAFLD is the drug metformin, which has similar properties to the newly discovered CTRP 3 protein which is part of a group of bioactive molecules secreted by adipose tissue, collectively termed adipokines (2-4). Both have similar effects on hepatic glucose and lipid metabolism and both specifically suppress hepatic gluconeogenesis (11, 17, 27, 29). The revolutionary Seahorse extracellular flux analyzer was used to measure the metabolism of H4IIE hepatocytes without use of radiolabeling (1). By detecting the Oxygen Consumption Rate (OCR) of hepatocytes the level of metabolic function within mitochondria can be measured. Once an effective protocol was established using this new technology, hepatocytes treated with metformin had a significantly lower OCR compared to control treated hepatocytes treated. However, H4IIE hepatocytes treated with metformin and palmitate had a significant increase in OCR and eventually equilibrated with the lower OCR of hepatocytes solely treated with metformin. With similar effect, hepatocytes treated with CTRP3 and palmitate caused a drastic increase in OCR while hepatocytes treated with only CTRP3 had a decrease in OCR. This suggests that CTRP3 increases fatty acid oxidation which decreases lipid concentrations within hepatocytes which could mean future protection of liver against NAFLD. In conclusion, our Seahorse XF analyzer models compare metformin and CTRP3’s similarities and suggest the possible liver protective functions of CTRP3. Our results will aid in future research of CTRP3 to further determine its possible uses as a treatment for liver-associated diseases.

Alcoholic fatty liver disease (AFLD) is a significant public health concern. Excessive alcohol (ethanol) consumption causes liver cell damage and death, which results in eventual failure of the liver and death. AFLD is the number one cause of liver-related mortality in the United States. Our lab works with the novel protein C1q TNF Related Protein 3 (CTRP3), which inhibits non-alcoholic fatty liver disease, however the effects on AFLD are unknown. Therefore, the purpose of this experiment is to determine if CTRP3 prevents ethanol-induced liver cell death. The H4IIE rat hepatoma cell line was chosen for experimentation as a cell culture model of liver tissue. To determine a suitable alcohol level H4IIE cells were treated with 50, 100, and 200 mmol of ethanol for 18-24 hours. Trypan Blue was used to identify the dead/damaged cells, as only dead/damaged cells will be stained blue with this protocol. We observed that 100 mmol of ethanol consistently induced ~10% mortality rate in these cells. Next, we tested the ability of CTRP3 to reduce ethanol-induced mortality. We added purified CTRP3 protein to the cell media along with the 100 mmol ethanol treatment. The addition of CTRP3 reduced the amount of alcohol-induced cell death/damage in the H4IIE cell line by approximately 60%. Our next goal was to determine how CTRP3 reduces ethanol-induced death. The Akt signaling pathway is a well-known inhibitor of cell death. Therefore, to determine if CTRP3 attenuated ethanol-induced cell damage/death through activation of the Akt signaling pathway, another set of cells was treated with 100 mmol of ethanol and CTRP3 (with or without insulin). Western blots were used to compare the amount of active Akt (phosphorylated) in the CTRP3-treated and non-treated cells. A Western blot utilizes an electric current to separate denatured protein samples on a SDS-page gel, separating the proteins based on size. The smaller the protein the faster it migrates across the gel. The proteins are then transferred to a membrane for analysis, through exposure to commercial antigens and chemiluminescence imaging. There was no change in the amount of total or active Akt between the samples treated with or without CTRP3. We conclude that CTRP3 protects liver cells from ethanol-induced damage/death, but not through activation of the Akt pathway.

Alcohol abuse is the third leading cause of preventable death in the United States. Excessive intake of alcohol can result to alcoholic fatty liver disease, the number one cause of live related mortalities in the US. The outlining purpose for this project is to determine the alcohol-induced changes in the liver cell protein signaling. For this project, we treated H4IIE rat hepatoma cells (with 100 and 200 mM ethanol overnight). H4IIE cells were chosen because they are a commonly used liver cell culture line that maintains characteristics of intact liver cells. After treatment we collected and prepared the cells for protein signaling analysis, using standard western blotting procedure. A western blot detects relative quantity of proteins in a sample. Briefly, protein samples are separated by size through electrophoresis, smaller proteins move faster through the gel so that the larger proteins are toward the top and smaller towards the bottom. The proteins are then transferred to a nitrocellulose membrane and protein concentration is detected by chemiluminescence. We chose to examine the effects of ethanol on the activation of the key regulator of metabolic signaling, Protein Kinase B/Akt (Akt). Based on our results, ethanol has no effect on the total amount of Akt in the H4IIE liver cells. However, ethanol significantly attenuates insulin-induced activation of Akt in a dose-dependent manner, as seen by a reduction in the amount of phosphorylated Akt. Therefore, we conclude that treatments that increase Akt activation may be a viable option for the treatment of alcoholic fatty liver disease.

No description available.

Over the past five decades, per capita caloric intake has increased by approximately 28% in the United States. A hallmark of the current standard American diet is an excess of energy sources from saturated fat and refined carbohydrates. High energy diets such as the “Western” diet cause numerous pathologies, including non-alcoholic fatty liver disease (NAFLD), high blood pressure, dyslipidemia, and peripheral insulin resistance. High energy diets also negatively impact the hippocampus, a brain area important for learning and memory. It is not surprising, then, that high energy diets impair hippocampal-dependent memory. The experiments in this dissertation investigate possible diet-induced consequences that may contribute to the impairing effects of high energy diets on hippocampal-dependent memory. Our initial experiments found that diet-induced NAFLD impairs hippocampal-dependent memory, but these cognitive deficits were not due to decreases in insulin-like growth factor-1 (IGF-1) or hippocampal insulin signaling. Next, we found that a high energy diet increased the ability of epinephrine to increase blood glucose concentrations, indicating a novel way in which high energy diets impair liver function. The final set of experiments found that high energy diets do not necessarily impair memory but instead may prevent the memory-enhancing effects of acute stress. Taken together, these results indicate that high energy diets interact with acute stress to negatively impact hippocampal-dependent memory, and that hippocampal insulin resistance and IGF-1are not likely involved.

Nonalcoholic fatty liver disease (NAFLD) has become a worldwide, chronic liver disease of increasing clinical significance. It is closely associated with the rising epidemics of obesity and insulin resistance. Up to 17% of the United States population may progress from the disease stage characterized as simple, benign steatosis to the more severe, inflammatory stage of nonalcoholic steatohepatitis (NASH). This progression occurs through 2nd 'hits' of increased oxidative stress and inflammation to a liver that has been sensitized by lipotoxic stress. NASH is also characterized by increased collagen deposition resulting in fibrosis and architectural rearrangement of the liver. Progressive NAFLD is currently recognized as an important contributor to the development of cryptogenic cirrhosis and subsequent liver-related mortalities (estimated at 30-40% in these patients).The pathological progression of NAFLD, as described by the 'two hit' hypothesis, characterizes the different stages of liver injury. However, the mechanism(s) responsible for the progression to NASH are unknown. Profiling global gene expression and metabolite patterns in human liver samples representing the full spectrum of progressive human NAFLD may reveal potential mechanisms of progressive disease. Human liver samples representing each stage of NAFLD progression were analyzed by methodologies such as high-throughput microarrays, high resolution mass spectrometry, and protein immunoblot techniques. Bioinformatics tools and gene expression/regulation database software were utilized in several studies to characterize the altered hepatic profiles of these patients. Hepatic transcriptomic profiles of ADME (absorption, distribution, metabolism and elimination) and ER (endoplasmic reticulum) stress response genes exhibited initiated hepatoprotective responses in patients with NASH. The endogenous pathways of BA (bile acid) synthesis and BCAA (branched chain amino acid) metabolism also showed evidence of coordinately regulated alterations in response to disease-induced stress in NASH. The transcriptional regulation of the investigated pathways was confirmed by transcription factor binding sites enrichment analysis. The collective response to hepatic stress in human NAFLD, demonstrates a coordinated, hepatoprotective intent that may be utilized for future therapeutics in the battle against progressive liver disease.

This study used the non-alcoholic steatohepatitis activity index (NAI), presence of fibrosis and Mallory-Denk bodies (MDBs), and quantification of glucose regulated protein 78 (GRP78) messenger ribonucleic acid (mRNA) as indicators of steatohepatitis development and recovery in the American mink (Neovison vison). Mink were fasted for 0, 1, 3, 5, or 7 days, and one group re-fed 28 days post 7-day fast. Liver NAI indicated that moderate fatty liver developed after 5 days of fasting. Liver recovery was achieved after the re-feeding period. There was no evidence of fibrosis or MDB formation. Upregulation of GRP78 was observed by day 7 of fasting indicating endoplasmic reticulum stress. This effect was greater in females. Results suggest that liver steatosis did not advance to steatohepatitis within a 7-day fast. However, should the length of fast be increased the mink may be at risk. Results also show that liver recovery from simple fatty liver is possible.