What is Nonalcoholic Steatohepatitis (NASH)
Non alcoholic steato hepatitis (NASH) is the progressive disease of the liver due to inflammation and damage caused by a buildup of fat in the liver. Over a period of time NASH may result in progressive Liver Fibrosis, Ultimately resulting in Cirrhosis.
What Causes NASH
We can say it is due to the emerging epidemics of Obesity (too much of food esp fats and sugars) and metabolic syndrome
They could be :
- Increased blood sugar
- Abnormal cholesterol or high triglyceride levels
- Insulin resistance and type 2 diabetes
- Excess Fat around the waist and stomach
What is Liver Fibrosis
It is the mild scarring of the liver which is due to continuous the liver damage caused by persistent inflammation. This mild scar can interfere with the blood flow to the liver depriving the liver cells of blood supply causing more damage to the liver if not treated.
What is Liver Cirrhosis
Cirrhosis is a condition in which liver function slowly deteriorates and is unable to function normally due to chronic or long lasting injury. It is a late stage of scarring ( fibrosis ) of the liver replaces healthy liver tissue and partially blocks the flow of blood through liver. Cirrhosis can cause fatigue, difficult to think clearly, fluid in the abdomen, bleeding in the intestine and poor blood clotting.
What are the signs and symptoms of NASH
It is a silent disease which shows few or no symptoms at the initial stage. The few symptoms we can observe is tiredness, pain on the upper right side of the abdomen.
What is the burden of NASH Worldwide and in India?
TChronic liver diseases and the consequences of end stage liver disease are increasing globally despite improved prevention and treatment of viral hepatitis. We see around 6 to 37% of prevalence worldwide. In USA it has been estimated 2 to 5% which is equivalent to approximately 16 million adults.
Simple fatty liver is very common in India with a prevalence of 35 to 45%. This simple fatty liver can go to the next stage of NASH which is seen around 5-8% population in India.
What is new in the management for NASH?
Gilead (A leader in Liver field) has come up with a promising drug to treat NASH which is known as SELONSERTIB (SEL). SEL is a potent inhibitor of apoptosis signal regulating kinase 1( ASK1). Ask is activated by pathological oxidative stress. SEL blocks the action of ASK1 and is expected to halt progressive liver fibrosis and reverse existing fibrosis, thus preventing the development of cirrhosis & related complications.