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Non-alcoholic fatty liver disease (NAFLD): an emerging major cause of progressive chronic liver disease
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Academic year 2020/2021
- Teacher
- Prof. Maurizio Parola (Titolare del corso)
- Teaching period
- Da definire
- Type
- Altre attività
- Credits/Recognition
- 1
- Course disciplinary sector (SSD)
- MED/04 - patologia generale
- Language
- Inglese
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Sommario del corso
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Course objectives
The aim of the initiative is to offer to PhD students major and up-to-date information on basic as well as clinically relevant issues related to the emerging problem represented by progressive NAFLD, which is now recognized as a leading cause of morbidity and mortality worldwide.
The Teaching of “Non-alcoholic fatty liver disease (NAFLD): an emerging major cause of progressive chronic liver disease” will offer a contribution to the realization of the objectives of the PhD course in Experimental Medicine and Therapy. Teaching provides the tools that enable PhD students to acquire appropriate knowledge on: (i) NAFLD epidemiology, genetic/epigenetic issues and clinical issues; (ii) basic mechanisms underlying the progression of NAFLD-related chronic liver disease with a focus on chronic inflammatory response and fibrogenic progression; (iii) the morphological and liver specific patterns of fibrosis; iv) pre-clinical studies and clinical trials related to NAFLD - targeted therapy.
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Course delivery
Lecturing by selected experts in the field integrated by open discussion and analysis of suggested reading.
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Learning assessment methods
Learning assessment will be performed by a ECM-like approach, with PhD students asked to respond to organ/tissue fibrosis – related specific questions by filling out a multiple choice questionnaire.
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Program
Background. Liver fibrosis, cirrhosis and hepatocellular carcinoma represent common pathological outcomes of chronic liver diseases (CLDs) of different etiology resulting in chronic tissue injury and inflammatory response as well as excessive deposition of extracellular matrix (ECM) components. Non-alcoholic fatty liver disease (NAFLD) has recently emerged as the most common cause of chronic liver disease worldwide being characterized by a 25% global prevalence in the general population and an even higher prevalence among obese individuals and/or Type II diabetes mellitus patients. According to current estimates approx. 25-30% of NAFLD patients can develop with the time non-alcoholic steatohepatitis (NASH), the progressive form of disease characterized by hepatocyte injury and lobular inflammation that can undergo progression towards advanced fibrosis, cirrhosis and eventually liver failure. Moreover, progressive NAFLD is also emerging as a major cause of hepatocellular carcinoma (HCC, i.e. the most common primary liver cancer) which currently represents the 3rd leading cause of cancer mortality worldwide being graved by a very bad prognosis due to still unsatisfying available therapeutic option.
Program of the activity. According to the overall health impact of NAFLD on the general population the proposed activity is designed to offer up-to-date information on the problem of NAFLD fibrogenic progression and HCC development. The activity will be structured in a number of lectures dedicated to the following major topics pertinent to this kind of CLD:
- NAFLD: epidemiological, genetic and clinical issues (Prof. Elisabetta Bugianesi, University of Torino)
- Lipotoxicity and other basic issues in NAFLD progression (Prof. Fabio Marra, University of Florence);
- Macrophages and their role in NAFLD progression (Prof. Fabio Marra, University of Florence);
- Liver myofibroblasts as key cells in NAFLD progression (Prof. Maurizio Parola, University of Torino;
- NAFLD and the development of hepatocellular carcinoma: basic and clinical issues (HCC) (Prof. Bugianesi and Parola, University of Torino)
Suggested readings and bibliography
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- Weiskirchen R et al. Organ and tissue fibrosis: molecular signals, cellular mechanisms and translational implications. Mol Asp Med 2019, 65:2-15.
- Parola M, Pinzani M. Liver fibrosis: pathophysiology, pathogenetic targets and clinical issues. Mol Asp Med 2019, 65:37-55.
- Younossi Z, Tacke F, Arrese M, Chander Sharma B, Mostafa I, Bugianesi E, et al. Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis. Hepatology. 2019;69:2672-82.
- McPherson S, Hardy T, Henderson E, Burt AD, Day CP, Anstee QM. Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies: Implications for prognosis and clinical management. J Hepatol 2015;62:1148-1155.
- Torres DM, Harrison SA. Nonalcoholic steatohepatitis and noncirrhotic hepatocellular carcinoma: fertile soil. Semin Liver Dis 2012;32:30-8.
- 6. Younes R, Bugianesi E. Should we undertake surveillance for HCC in patients with NAFLD? J Hepatol. 2018;68:326-34. doi: 10.1016/j.jhep.2017.10.006.
- Younossi Z, Stepanova M, Ong JP, Jacobson IM, Bugianesi E, Duseja A, et al. Nonalcoholic Steatohepatitis Is the Fastest Growing Cause of Hepatocellular Carcinoma in Liver Transplant Candidates. Global Nonalcoholic Steatohepatitis Council. Clin Gastroenterol Hepatol. 2019;17:748-55.e3. doi: 10.1016/j.cgh.2018.05.057.
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