Serum ferritin and liver inflammation: which come first?

Chicken or egg? 

Autor: Bellentani Stefano

Fragmento

Inflammation is not the cause of an elevated serum ferritin in non-alcoholic fatty liver disease Beaton MD, et al. For the clinician the serum elevation of ferritin in chronic liver diseases (CLD), with the exception of Emochromatosis, is always assumed to be a non-specific marker of hepatic inflammation and not of iron overload. Nonalcoholic fatty liver disease (NAFLD) is now the most common cause of CLD. The spectrum of NAFLD is ranging from simple steatosis through nonalcoholic steatohepatitis (NASH). Iron is regarded as a putative element that interacts with oxygen radicals, and high rates of hyperferritinemia together with increased hepatic iron stores have been demonstrated in NASH. The role of hepatic iron in the progression and in the pathogenesis of NASH remains controversial. We know that phlebotomy or iron-restricted diet reduce hepatic damage as well as insulin resistance (IR) in patients with NAFLD/NASH. However, exact mechanisms involved in iron accumulation in NASH remain to be clarified. Genetic factors linked to IR, dysregulation of iron-regulatory molecules, erythrophagocytosis by Kupffer cells may be responsible for hepatic iron overload in NASH.

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2014-04-11   |   361 visitas   |   Evalua este artículo 0 valoraciones

Vol. 13 Núm.3. Mayo-Junio 2014 Pags. 315-316 Ann Hepatol 2014; 13(3)