What's the role of Kupffer cells in non-alcoholic steatohepatitis?

Nonalcoholic steatohepatitis (NASH) is a disorder characterized by hepatic steatosis, inflammation and fibrosis with a risk of developing cirrhosis and hepatocellular carcinoma (HCC). The progression from simple steatosis to cirrhosis has been attributed to inflammatory cytokines such as tumor necrosis factor alpha (TNF-), oxidative stress and endotoxin, in combination with fatty degeneration due to insulin resistance. At present, histopathological examination of liver biopsy tissue is the only way to definitively diagnose NASH. The diagnosis of NASH is important in clinical hepatology, as this common disease is known to progress to hepatic cirrhosis and finally HCC.

A research article to be published on October 21, 2008 in the World Journal of Gastroenterology addresses this question. The research team was led by Tatsuhiro Tsujimoto from Nara Medical University of Japan.

Kupffer cells and hepatic sinusoidal function can be evaluated using the contrast effect in the liver parenchymal phase during CEUS examination using Levovist®, strongly implicating Kupffer cells in the pathogenesis of NASH. Reduced function or uneven distribution of Kupffer cells in the liver may play a part in this phenomenon, although this is no more than conjecture at this stage. In this study, authors investigated the contrast effect in the liver parenchymal phase of CEUS using Levovist®, as well as Kupffer cell dynamics and phagocytic activity.

The diagnosis of NASH is important in clinical hepatology, as this common disease is known to progress to hepatic cirrhosis and eventually to HCC. At present, histopathological examination of liver biopsy tissue is the only way to definitively diagnose NASH. When patients with NASH undergo CEUS examination using Levovist®, a reduced contrast effect is seen in the liver parenchymal phase. They investigated Kupffer cell dynamics and phagocytic activity using a rat NASH model.

This report shows the contrast effect in the liver parenchymal phase of CEUS using Levovist®, as well as detailed Kupffer cell dynamics and phagocytic activity in the rat NASH model. The results confirmed the effectiveness of CEUS examination in diagnosing NASH. Authors expect that the CEUS examination using Levovist® is useful screening examination which picks up NASH among fatty liver patients.

Reference: Tsujimoto T, Kawaratani H, Kitazawa T, Hirai T, Ohishi H, Kitade M, Yoshiji H, Uemura M, Fukui H. Decreased phagocytic activity of Kupffer cells in the rat nonalcoholic steatohepatitis model. World J Gastroenterol 2008; 14(39): 6036-6043 http://www.wjgnet.com/1007-9327/14/6036.asp

Correspondence to: Tatsuhiro Tsujimoto, MD, PhD, Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. tat-tyan@xa2.so-net.ne.jp Telephone: +81-744-223051 Fax: +81-744-247122

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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