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New therapy option for non-alcoholic fatty liver
Fatty liver is the most common liver finding in Germany and at the same time the basis for severe liver diseases such as cirrhosis and liver cancer, but also for heart diseases. So far there is no real therapy for fatty liver, apart from promoting the body's regenerative power through a healthy lifestyle. A research team from Vienna has now found a way to treat fatty liver. Synthetic bile acid is passed through the body, which leads the liver back to its healthy function.
Researchers at the Medical University of Vienna found that the active ingredient nor-ursodeoxycholic acid (Nor-Urso) is suitable for the treatment of non-alcoholic fatty liver. The drug had previously had good results in the previously incurable liver disease, primarily sclerosing cholangitis (PSC), whereupon the research team expanded the area of application. The study results were recently presented in the renowned journal "The Lancet".
Common disease fatty liver
"More than a quarter of the people in Austria suffer from non-alcoholic fatty liver," warn the doctors at MedUni Vienna. It doesn't look better in Germany. According to the Gastro-Liga, between 20 and 30 percent of the German population are affected - with an increasing tendency. The proportion would even be 50 percent among diabetics. The most common cause is usually an unhealthy lifestyle with an overly fatty and sweet diet, coupled with a lack of exercise and being overweight, the experts emphasize.
High number of unreported cases
A big problem with the treatment of fatty liver is that it is often not recognized. A fatty liver initially does not cause any symptoms and is therefore often an accident. Even if there are no symptoms, fatty liver poses a significant threat to health, because the long-term consequences include serious diseases such as cirrhosis of the liver and liver cancer. According to the researchers, liver cirrhosis occurs in 15 to 25 percent of all cases with a pronounced fatty liver.
New treatment option discovered
"Our now completed Phase II-a study with Nor-Urso with the participation of numerous Austrian and German centers shows positive results when used with non-alcoholic fatty liver," says study author Stefan Traussnigg from MedUni Vienna. The synthetic bile acid protects the liver from inflammation and helps the organ to return to its healthy function.
How does bile acid help the liver?
The researchers take advantage of the hormone effects of bile acid. "Bile acid circles through the body like a steroid hormone and regulates many metabolic processes," explains research director Michael Trauner. Since the bile acid signal becomes resistant in the course of fatty liver, the liver no longer functions properly. The synthetic bile acid Nor-Urso strengthens the hormone effect of bile acid again, which improves the course of the disease.
Higher risk of premature death
As the doctors at MedUni Vienna report, the most common cause of death from fatty liver disease is heart disease (heart attack) or strokes. This is sometimes due to the fact that fatty liver increasingly releases proteins that damage the blood vessels. In further studies, the research team would now like to investigate whether synthetic bile acid can also reduce the risk of a heart attack or stroke as a result of fatty liver. The life expectancy of those affected could thus generally be improved. "It would be logical to expect that and we are also confident," comments Trauner.
Further therapy against fatty liver in the starting blocks
In addition to the results mentioned above, the research team was able to gain further insights. The team found that the important bile acid receptor FXR is involved in numerous processes such as the regulation of lipid and glucose metabolism and the synthesis and circulation of bile acids. Activation of this receptor also had a positive effect on the healing of fatty liver and primary biliary cholangitis (PBC). There are currently two options available to activate the FXR bile acid receptor. On the one hand, the activation can take place via obeticholic acid, on the other hand via so-called non-steroidal FXR ligands. "With these promising options, we have three further options for individual treatment in the sense of personalized medicine, which take advantage of the signal properties and hormone effects of bile acids," summarizes Trauner. In the future, those affected will be better able to get fatty liver, said the head of research. (vb)
Further interesting information on this topic can be found here:
- Fatty liver: causes and therapy
- Danger from fatty liver: This is the only way to keep the liver healthy
- Metabolic syndrome and fatty liver: These everyday risks make our liver suffer
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
- Traussnigg, Stefan / Schattenberg, Jörn M. / Demir, Münevver: Norursodeoxycholic acid versus placebo in the treatment of non-alcoholic fatty liver disease: a double-blind, randomized, placebo-controlled, phase 2 dose-finding trial, The Lancet Gastroenterology & Hepatology, 2019, thelancet.com
- Medical University of Vienna: New therapy option for non-alcoholic fatty liver (accessed: August 2, 2019), meduniwien.ac.at