Overweight has become a major health care problem in Western societies and is accompanied by an increasing incidence and prevalence of non-alcoholic fatty liver disease (NAFLD). The progression from NAFLD to non-alcoholic steatohepatitis (NASH) marks a crucial tipping point in the progression of severe and irreversible liver diseases. This study aims to gain further insight into the molecular processes leading to the evolution from steatosis to steatohepatitis. Steatosis was induced in cultures of primary human hepatocytes by continuous five-day exposure to free fatty acids (FFAs). The kinetics of lipid accumulation, lipotoxicity, and oxidative stress were measured. Additionally, ER stress was evaluated by analyzing the protein expression profiles of its key players: PERK, IRE1a, and ATF6a. Our data revealed that hepatocytes are capable of storing enormous amounts of lipids without showing signs of lipotoxicity. Prolonged lipid accumulation did not create an imbalance in hepatocyte redox homeostasis or a reduction in antioxidative capacity. However, we observed an FFA-dependent increase in ER stress, revealing thresholds for triggering the activation of pathways associated with lipid stress, inhibition of protein translation, and apoptosis. Our study clearly showed that even severe lipid accumulation can be attenuated by cellular defenses, but regenerative capacities may be reduced.

Nonalcoholic fatty liver disease (NAFLD) is among the leading causes of end-stage liver disease. The impaired hepatic lipid metabolism in NAFLD is exhibited by dysregulated PPARα and SREBP-1c signaling pathways, which are central transcription factors associated with lipid degradation and de novo lipogenesis. Despite the growing prevalence of this disease, current pharmacological treatment options are unsatisfactory. Genistein, a soy isoflavone, has beneficial effects on lipid metabolism and may be a candidate for NAFLD treatment. In an in vitro model of hepatic steatosis, primary human hepatocytes (PHHs) were incubated with free fatty acids (FFAs) and different doses of genistein. Lipid accumulation and the cytotoxic effects of FFAs and genistein treatment were evaluated by colorimetric and enzymatic assays. Changes in lipid homeostasis were examined by RT-qPCR and Western blot analyses. PPARα protein expression was induced in steatotic PHHs, accompanied by an increase in CPT1L and ACSL1 mRNA. Genistein treatment increased PPARα protein expression only in control PHHs, while CPTL1 and ACSL1 were unchanged and PPARα mRNA was reduced. In steatotic PHHs, genistein reversed the increase in activated SREBP-1c protein. The model realistically reflected the molecular changes in hepatic steatosis. Genistein suppressed the activation of SREBP-1c in steatotic hepatocytes, but the genistein-mediated effects on PPARα were abolished by high hepatic lipid levels.

The aim of this exploratory study was to evaluate the influence of hepatic steatosis on the detection rate of metastases in gadoxetic acid-enhanced liver magnetic resonance imaging (MRI). A total of 50 patients who underwent gadoxetic acid-enhanced MRI (unenhanced T1w in- and opposed-phase, T2w fat sat, unenhanced 3D-T1w fat sat and 3-phase dynamic contrast-enhanced (uDP), 3D-T1w fat sat hepatobiliary phase (HP)) were retrospectively included. Two blinded observers (O1/O2) independently assessed the images to determine the detection rate in uDP and HP. The hepatic signal fat fraction (HSFF) was determined as the relative signal intensity reduction in liver parenchyma from in- to opposed-phase images. A total of 451 liver metastases were detected (O1/O2, n = 447/411). O1/O2 detected 10.9%/9.3% of lesions exclusively in uDP and 20.2%/15.5% exclusively in HP. Lesions detected exclusively in uDP were significantly associated with a larger HSFF (area under curve (AUC) of receiver operating characteristic (ROC) analysis, 0.93; p < 0.001; cutoff, 41.5%). The exclusively HP-positive lesions were significantly associated with a smaller diameter (ROC-AUC, 0.82; p < 0.001; cutoff, 5 mm) and a smaller HSFF (ROC-AUC, 0.61; p < 0.001; cutoff, 13.3%). Gadoxetic acid imaging has the advantage of detecting small occult metastatic liver lesions in the HP. However, using non-optimized standard fat-saturated 3D-T1w protocols, severe steatosis (HSFF > 30%) is a potential pitfall for the detection of metastases in HP.

Overweight has become a major health care problem in Western societies and is accompanied by an increasing incidence and prevalence of non-alcoholic fatty liver disease (NAFLD). The progression from NAFLD to non-alcoholic steatohepatitis (NASH) marks a crucial tipping point in the progression of severe and irreversible liver diseases. This study aims to gain further insight into the molecular processes leading to the evolution from steatosis to steatohepatitis. Steatosis was induced in cultures of primary human hepatocytes by continuous five-day exposure to free fatty acids (FFAs). The kinetics of lipid accumulation, lipotoxicity, and oxidative stress were measured. Additionally, ER stress was evaluated by analyzing the protein expression profiles of its key players: PERK, IRE1a, and ATF6a. Our data revealed that hepatocytes are capable of storing enormous amounts of lipids without showing signs of lipotoxicity. Prolonged lipid accumulation did not create an imbalance in hepatocyte redox homeostasis or a reduction in antioxidative capacity. However, we observed an FFA-dependent increase in ER stress, revealing thresholds for triggering the activation of pathways associated with lipid stress, inhibition of protein translation, and apoptosis. Our study clearly showed that even severe lipid accumulation can be attenuated by cellular defenses, but regenerative capacities may be reduced.

La protéine core du virus de l’hépatite C (VHC) serait responsable des principaux effets pathogènes du VHC, dont le développement de fibrose, stéatose, cirrhose et carcinome hépatocellulaire. Un cadre de lecture alternatif existe dans le gène de core, permettant la synthèse d’une autre protéine appelée ARFP (pour alternatate reading frame protein) ou protéine F (pour frameshift), dont le rôle reste encore mal compris. La présence de la protéine F lors de l’étude des fonctions biologiques de core ne pouvant être exclue, il est possible que certains rôles attribués à core reflètent en réalité l’activité de la protéine F. Afin de déterminer les fonctions biologiques de la protéine F dans les hépatocytes et son influence dans la pathogenèse associée au VHC, nous avons généré des lignées transgéniques de poissons zébrés (Danio rerio) dans lesquelles l’expression de deux versions de la protéine F (AF11opti et AUG26opti) a été ciblée au foie par l’utilisation du promoteur de la liver fatty acid binding protein (L-FABP). Le phénotype des poissons transgéniques de génération F2 a été analysé au niveau morphologique, histologique et microscopique afin de rechercher des signes de pathologie hépatique. Nos résultats ont démontré l’implication de la protéine F dans le développement de stéatose hépatique chez les deux lignées transgéniques, mais aucun signe de fibrose ou d’oncogenèse n’a été détecté. L’identification des mécanismes cellulaires et moléculaires responsables de l’accumulation lipidique induite par la protéine F pourrait permettre de mieux comprendre son rôle dans la pathogenèse du VHC, et mener au développement de nouvelles stratégies antivirales. / Hepatitis C virus (HCV) core protein is thought to be responsible for the major pathogenic effects of HCV, including the development of fibrosis, steatosis, cirrhosis, and hepatocellular carcinoma. An alternate translational open reading frame exists in the core gene that allows the synthesis of another protein called ARFP (alternate reading frame protein) or F protein (frameshift), the role of which remains poorly understood. Since we cannot exclude the presence of F protein in most studies of core biological functions, it is possible that the roles attributed to core reflect the activity of ARFP. To determine the biological functions of F protein in hepatocytes and their influence on HCV-associated pathogenesis, we generated transgenic lines of zebrafish (Danio rerio) in which the liver fatty acid binding protein (L-FABP) promoter was used to direct liver-specific expression of two forms of ARFP (AF11opti and AUG26opti). The phenotype of F2 transgenic zebrafish was analyzed for morphological, histological and microscopic signs of liver-associated pathology. Our results demonstrated the implication of the HCV F protein in the development of hepatic steatosis in transgenic zebrafish liver but not fibrosis or oncogenesis. Identification of the cellular and molecular mechanisms underlying F protein-induced lipid accumulation will lead to a better understanding of the role of ARFP in HCV-associated pathology, which could lead to the development of novel antiviral strategies.

Introdução: Os efeitos metabólicos do uso combinado dos triglicerídeos de cadeia média (TCM) e do óleo de peixe (OP) na esteatose hepática ainda não estão totalmente esclarecidos. Objetivo: O presente estudo teve o objetivo de verificar os efeitos da combinação dos TCMs e OP na esteatose hepática e estresse oxidativo induzidos pela dieta hiperlipídica (HL+) termolizada em ratos. Material e Métodos: Foram utilizados no total 50 ratos machos da linhagem Wistar. O grupo Controle (n=10) recebeu a dieta controle. Os grupos HL+ receberam a dieta contendo 50% de gordura animal (GA) termolizada e 50% de ração. A adaptação às dietas HL+ foi realizada durante 5 dias. Os grupos HL+GA, HL+TCM, HL+OP e HL+TCM/OP (n=10) receberam a dieta HL+ com 50% de lipídios (gordura animal termolizada) durante 30 dias. Após este período, os grupos HL+TCM, HL+OP e HL+OP/TCM receberam as dietas HL+ adicionadas de óleo de TCM (OTCM), OP e OTCM + OP, respectivamente, durante 20 dias. As análises realizadas foram a gordura hepática total, frações lipídicas hepáticas e séricas, glicemia, vitamina E e retinol séricos, glutationa reduzida (GSH) e malondialdeído (MDA) sérico e hepático e aminotransferases séricas. Resultados: Os grupos HL+ apresentaram acúmulo significativo de gordura total e triglicerídeos hepáticos, exceto o HL+OP. Apenas o grupo HL+TCM não apresentou acúmulo significativo de colesterol total hepático (CT). Este mesmo grupo apresentou valores maiores de CT e HDLcol séricos e menor razão triglicerídeos/HDLcol. Os valores séricos de aminotransferases foram significativamente maiores nos grupos que receberam os OTCM e/ou OP. A peroxidação lipídica (LPO) hepática foi maior foi nos grupos HL+, exceto o HL+TCM. Apenas o grupo HL+GA apresentou maior LPO sérica. Verificou-se que a GSH foi maior nos grupos HL+GA, HL+TCM e HL+OP/TCM, a vitamina E sérica foi menor nos grupos HL+GA, HL+OP e HL+OP/TCM e o retinol sérico foi maior nos grupos HL+GA e HL+TCM. Conclusões: As alterações séricas não refletiram as alterações hepáticas em relação aos lipídios, estresse oxidativo e antioxidantes. O uso do óleo de TCM e óleo de peixe em associação na dieta HL+ resultou em efeito negativo devido ao maior acúmulo de gordura hepática tanto na forma de triglicerídeos quanto de colesterol, maior peroxidação lipídica hepática e menor vitamina E sérica. / Introduction: The metabolic effects of combined use of medium chain triglycerides (MCT) and fish oil (FO) on non alcoholic hepatic steatosis are not fully understood. Objective: The aim of this study was to investigate the effects of the combination of MCT and FO on hepatic steatosis and oxidative stress induced by high fat (HF+) thermolyzed diet in rats. Methodology: Fifty wistar male rats were studied. The Control group (n = 10) received the standard diet. The HF+ groups received diet with 50% of thermolyzed animal fat (AF) and 50% of ration. Five days were dedicated for adaptation to high-fat diets. The groups HF+AF, HF+MCT, HF+FO and HF+MCT/FO (n = 10) received HF+ diet with 50% thermolyzed fat during 30 days. After this period, the groups HF+MCT, HF+FO and HF+MCT/FO received HF+ diets with MCT oil (MCTO), FO and MCTO + OP, respectively, during 20 days. Analysis of total liver fat, liver and serum lipid fractions, serum glucose, vitamin E and retinol, serum and liver reduced glutathione (GSH) and malondialdehyde (MDA), and serum aminotransferases (AST and ALT) were performed. Results: The groups HF+ showed higher total fat and triglycerides, except HF+FO. Only HF+MCT group didn´t have higher liver total colesterol (TC). This same group had higher serum TC and HDLcol and lower triglycerides/HDLcol ratio. The groups fed with MCTO and/or FO had higher serum aminotransferase. Liver lipid peroxidation (LPO) was higher in HF+ groups, except HF+MCT. Serum LPO was higher in HF+AF. The hepatic GSH was higher in the groups HF+AF, HF+MCT and HF+MCT/FO, serum vitamin E was lower in groups HF+AF, HF+FO and HF+MCT/FO, and serum retinol was higher in groups HF+AF and HF+MCT. Conclusions: Lipids, oxidative stress and antioxidant serum and liver alterations didnt correspond. The association of MCTO with FO in HF+ diet resulted in a negative effect when it concerns liver fat, triglyceride and cholesterol accumulation, higher liver lipid peroxidation and lower serum vitamin E.

Este trabalho investigou os efeitos do CLA sobre o metabolismo lipídico na caquexia. Grupos controle ou tumor foram suplementados com CLA, óleo de girassol ou salina, por gavagem, por 14 dias. O peso corporal, ração, glicose, colesterol, TAG, insulina e leptina plasmáticos, glicogênio, proteína, TAG, expressão gênica da CPT I and II, MTP, L-FABP, PPAR-&#945 e apoB, o conteúdo proteíco da apoB e a atividade máxima da CPT I e II no fígado, o conteúdo de gordura no TAE e TARP e a concentração proteíca e de IL-1&#946,IL-6,TNF-&#945 e IL-10 desses tecidos foram determinados. A atividade da CPT II mostrou-se reduzida em todos os grupos em relação a C. o mRNA da MTP, apoB e FABP foi inferior em todos os grupos TB, mas no TBCLA esta redução foi maior. Todos os grupos mostraram expressão diminuída de proteína apoB em relação a C. TBCLA aumentou o TAG hepático e plasmático, assim como colesterol e glicose quando comparado com os grupos TB. O TAG no TAE diminuiu em TBCLA em relação a C, TBSF e CCLA. Houve diminuição de IL-1&#946 no CCLA em relação a C, mas em TBCLA a IL-1&#946 foi superior em relação a C, TB e TBSF. TBCLA mostrou um aumento de IL-6 em relação a TB e CCLA. O TBCLA mostrou aumento de TNF-&#945 quando comparado com TB e CCLA. O CLA falhou em promover a recuperação do metabolismo lipídico em animais caquéticos. / We investigated the effects of CLA upon lipid metabolism in cachexia. Male Wistar rats were assigned to a control or cachetic rats, supplemented with CLA, sunflower oil or saline, for 14 days. Body weight, dietary intake, plasma glucose, cholesterol, insulin and leptin, and liver TAG, glycogen and protein, CPT I and II, MTP, L-FABP, PPAR-&#945, apoB gene expression, apoB protein content and the maximal activity of CPT I and II, were assessed. The fat content of EAT and RPAT, and adipose tissue IL-1&#946,IL-6,TNF-&#945 and IL-10 content were assessed. CPT II activity was reduced in all groups when compared with C. mRNA expression of MTP, apoB and FABP were reduced in all TB groups, but TBCLA showed the greatest reduction of apoB and MTP mRNA and apoB protein content. TBCLA increased liver and plasma TAG, cholesterol and glucose content, when compared with TB groups. TAG in EAT decreased in TBCLA group when compared with C, with TBSF, and with CCLA. Decreased IL-1&#946 in CCLA was found in relation to C, TBCLA enhanced IL-1&#946 in relation to C, TB and TBSF. TBCLA, increased IL-6 when compared with TB and CCLA. TBCLA showed higher TNF-&#945 in relation to TB and CCLA. We conclude that CLA fails promoting the re-establishment of lipid metabolism in cachexia.

Orientador: Maria Alice Rostom de Mello / Banca: Eduardo Kokubun / Banca: Camila Aparecida Machado de Oliveira / Resumo: O presente estudo visou analisar os efeitos do exercício de caráter aeróbio sobre marcadores de esteatose hepática não alcoólica (EHNA), tolerância à glicose, sensibilidade à insulina e capacidade aeróbia de ratos mantidos em dieta rica em frutose. Foram utilizados ratos da linhagem Wistar que foram separados em dois grupos, conforme a dieta recebida: controle (dieta balanceada AIN-93 G) e frutose (dieta com 60% de frutose). Esses animais foram submetidos a testes de máximo estado estável de lactato (MEEL) para a identificação da transição metabólica aeróbia/anaeróbia durante exercício de natação aos 28, 90 e 120 dias de idade. Um terço dos animais de cada grupo foi submetido ao treinamento por natação, em intensidade equivalente ao MEEL, 1 h/dia, 5 dias/semana dos 28 aos 120 dias (protocolo precoce), outro terço foi submetido ao mesmo treinamento dos 90 aos 120 dias (protocolo tardio) e os restantes, permaneceram sedentários. As principais análises efetuadas foram: capacidade aeróbia (MEEL), tolerância à glicose (oGTT); sensibilidade periférica à insulina (ITT); marcadores de EHNA (concentrações séricas de alanina aminotransferase [ALT], aspartato aminotransferase [AST], fosfatase alcalina e as concentrações hepáticas de lipídios [totais] e concentração de triglicerídeos séricos [TG]). O treinamento precoce reduziu a carga de trabalho no MEEL do lactato dos animais alimentados com ambas as dietas. Já o treinamento tardio aumentou essa carga de trabalho nos ratos alimentados com dieta controle. O treinamento tardio, também reduziu a área sob a curva de glicose durante GTT nos ratos controle. A dieta rica em frutose diminuiu a sensibilidade à insulina dos animais. No entanto, o protocolo de exercício tardio foi eficiente em melhorar esse aspecto. Não houve diferença entre os grupos nas concentrações de ALT séricas, no entanto ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study aimed to analyze the effects of aerobic exercise on markers of non alcoholic steatohepatitis (EHNA), glucose tolerance, insulin sensitivity and aerobic capacity of rats kept on a fructose rich diet. We used rats of Wistar strain which were separated into two groups according to diet: control (balanced diet AIN-93 G) and fructose (diet with 60% fructose). These animals were tested for maximum lactate steady state (MEEL) to identify the aerobic / anaerobic metabolic transition exercise during swimming at 28, 90 and 120 days of age. One third of the animals in each group was subjected to swimming training at intensity equivalent to MEEL, 1 h / day, 5 days / week from 28 to 120 days (early protocol), another third was submitted to the training from 90 to 120 days (late Protocol) and the others remained sedentary. The main tests performed were: aerobic capacity (MEEL), glucose tolerance (oGTT) peripheral sensitivity to insulin (ITT), markers of EHNA (serum alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase and hepatic concentrations of lipids [total], and concentration of serum triglycerides [TG]). The early protocol reduced the workload on MEEL in animals fed both diets. On the other hand, the later training increased work load in rats fed control diet. The later training, also reduced the areas under the glucose curve during oGTT in control rats. The fructose rich diet decreased sensitivity to insulin in these animals. However, the later exercise protocol was efficient in improving this. There was no difference between groups in concentrations of serum ALT, but the concentrations of AST increased in the fructose sedentary group compared to other groups. There was an increase in liver lipids of animals fed with fructose rich diet and sedentary. Serum concentrations of triglycerides were increased in high fructose trained groups compared with... (Complete abstract click electronic access below) / Mestre

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A influência da obesidade sobre o fígado e a função hepática é tema ainda pouco estudado e discutido, principalmente no Brasil. O crescente aumento da população obesa de maneira global alerta sobre esse grave problema, que hoje em dia, se torna de saúde pública. Amplia-se, cada vez mais, o número de pessoas e a faixa etária atingida. A doença hepática não alcoólica é uma condição clínico-patológica comum caracterizada por depósitos de lipídios em hepatócitos no parênquima hepático. Um espectro de danos ocorrem no parênquima, desde uma simples esteatose macrogoticular podendo evoluir para esteato-hepatite, fibrose e até cirrose. Os casos de esteatose hepática não alcoólica (EHNA) que progridem para cirrose tem sido reconhecidos como a maior causa de morbidade e mortalidade com potencial para progredir para falência hepática. Apesar de haver um aumento na prevalência da doença hepática não alcoólica, os critérios para seu diagnóstico continuam pobremente definidos. A utilização da espectroscopia de prótons na ressonância magnética auxilia na quantificação do conteúdo lipídico hepático e na musculatura da perna (tibial anterior e sóleo), embora venha sendo utilizada apenas em pesquisas. Tivemos como objetivos o estudo do metabolismo lipídico de humanos xii obesos por espectroscopia por ressonância magnética, correlacionando com dados laboratoriais e de biópsias hepáticas. Neste estudo observacional transversal e prospectivo realizado em obesos, que foram submetidos a cirurgia redutora gástrica pela técnica de Capella no Hospital Prof. Edmundo Vasconcelos em São Paulo, foram incluídos 27 pacientes analisados no pré e pós-operatório para descrição dos dados. Foi constatada uma razão masculino/feminino geral de 8 :19 e a faixa etária entre 24 e 55 anos. Os índices de massa corpórea (IMC) eram sempre superiores a 40 Kg/m² para inclusão cirúrgica. Os pacientes obesos que no pré-operatório apresentavam esteatose hepática observada na ressonância magnética e esteatose e/ou esteato-hepatite na biópsia hepática evoluíram com melhora ou resolução no pós-operatório. Em conclusão, em pacientes obesos o grau de esteatose hepática pode ser analisado qualitativa e quantitativamente através da ressonância magnética com espectroscopia assim como, o controle pós tratamento cirúrgico evitando-se a utilização de métodos invasivos, entre eles a biópsia hepática. / The obesity influence on the liver and the hepatic function are themes that are not so discussed or studied, especially in Brazil. The world-wide increasing number of obese people calls the attention to this serious problem, that nowadays, became a public health problem. The number of people and the age of the people who suffer from it is increasing each day more. The non-alcoholic hepatic disease is a common pathological clinic condition caractherized by lipid deposits in hemocytes in the hepatic parenchyma. There are some injuries in the parenchyma, since a single steatosy macrogoticular to a steatohepatitis, a fibrosis and even a cirrhosis (Sass et al., 2005). The non-alcoholic steatosy hepatic (NASH) cases which lead to a cirrhosis have been known as the main causes of death with possibilities to evolute to a hepatic fail. Besides there is an increasing in the non-alcoholic hepatic disease, the means for its diagnosis still remain poorly defined. The protons spectroscopy use, in the magnetic resonance, helps on the lipidic hepatic contents numbers, although it has been used only for researches. We had as a goal the lipid metabolism study of obese human beings, related to the laboratorials data and the hepatic biopsy. On this study, where we observed obese people that were submitted to a gastric reducing surgery by the Capella techinic in the hospital Prof. Edmundo Vasconcelos in São Paulo, were included 27 pacients analyzed on the before and after operation for the datas description. It was noted a male/female general reason 9: 18 and the ages between 24 and 55 years old. The body mass indexes (IMC) were always over 40 Kg/m² to be included in a surgery. The obese patients who presented steatosy hepatic before operatory observed on the magnetic resonance and steatosy and/or steatohepatitis during the hepatic biosy went better on the pos-operatory. Finally, in obese patients the xiv steatosy hepatic degree can be analysed on its qualitativy and quantitativy through the magnetic resonance with spectroscopy, and so the cirurgical pos- treatment control, avoiding the use of invasive methods, among them the hepatic biopsy.