Therapy of nonalcoholic steatohepatitis (NASH) – antioxidants and cytoprotective agents.

ABSTRACT

Pathogenesis of nonalcoholic fatty liver disease (NAFLD) and its progressive form nonalcoholic steatohepatitis (NASH) is not completely understood. Because of the role of oxidative stress in the pathogenesis, antioxidants and cytoprotective agents have been used in the treatment of patients with NAFLD/NASH. Various antioxidants and cytoprotective agents used in these patients include Vitamin E, Vitamin C, Betaine, N- acetyl cysteine, silybin, lecithin, beta carotene, metadoxine, selenium and ursodeoxycholic acid (UDCA). Most of the data is available with vitamin E and UDCA, either in isolation or in combination with various agents. The available data on the use of various agents are either experimental or have small number of patients and randomized controlled trials with histological efficacy are sparse. More data is required before any conclusions are drawn regarding the use of anti oxidants and cytoprotective agents in patients NAFLD/NASH.