Advertisement

Endocrine

, Volume 43, Issue 1, pp 65–67 | Cite as

A pathogenetic link between non-alcoholic fatty liver disease and celiac disease

  • Ludovico AbenavoliEmail author
  • Natasa Milic
  • Antonino De Lorenzo
  • Francesco Luzza
Viewpoint

Abstract

Non-alcoholic fatty liver disease (NAFLD) has recently been recognized as the leading cause of the abnormalities in the liver function tests in the Western countries. Celiac disease (CD) is a permanent immunological intolerance to gluten proteins in genetically predisposed individuals. CD has been reported in 4–13 % of the cases with steatohepatitis, although the pathogenesis of the liver steatosis in CD patients is unclear. Based on the literature data, it can be concluded that the inclusion of serological markers of CD should be a part of the general workup in the patients with steatosis when other causes of the liver disease are excluded and in the patients with NAFLD when metabolic risk factors are not evident.

Keywords

Non-alcoholic fatty liver disease Celiac disease Intestinal permeability Microbiota 

Notes

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    P. Angulo, Non-alcoholic fatty liver disease. N. Engl. J. Med. 346, 1221–1231 (2002)PubMedCrossRefGoogle Scholar
  2. 2.
    S. Bellentani, F. Scaglioni, M. Marino et al., Epidemiology of non-alcoholic fatty liver disease. Dig. Dis. 28, 155–161 (2010)PubMedCrossRefGoogle Scholar
  3. 3.
    G.A. Garinis, B. Fruci, A. Mazza et al., Metformin versus dietary treatment in nonalcoholic hepatic steatosis: a randomized study. Int. J. Obes. 34, 1255–1264 (2010)CrossRefGoogle Scholar
  4. 4.
    P.H. Green, C. Cellier, Celiac disease. N. Engl. J. Med. 357, 1731–1743 (2007)PubMedCrossRefGoogle Scholar
  5. 5.
    L. Maiuri, C. Ciacci, I. Ricciardelli et al., Association between innate response to gliadin and activation of pathogenic T cells in celiac disease. Lancet 362, 30–37 (2003)PubMedCrossRefGoogle Scholar
  6. 6.
    A. Vilppula, K. Kaukinen, L. Luostarinen et al., Increasing prevalence and high incidence of celiac disease in elderly people: a population-based study. BMC. Gastroenterol. 9, 49 (2009)PubMedCrossRefGoogle Scholar
  7. 7.
    U. Volta, Pathogenesis and clinical significance of liver injury in celiac disease. Clin. Rev. Allergy Immunol. 36, 62–70 (2009)PubMedCrossRefGoogle Scholar
  8. 8.
    C.P. Day, O.F. James, Steatohepatitis: a tale of two “hits”? Gastroenterology 114, 842–845 (1998)PubMedCrossRefGoogle Scholar
  9. 9.
    C.P. Day, Genes or environment to determine alcoholic liver disease and non-alcoholic fatty liver disease. Liver Int. 26, 1021–1028 (2006)PubMedCrossRefGoogle Scholar
  10. 10.
    S. Prakash, L. Rodes, M. Coussa-Charley et al., Gut microbiota: next frontier in understanding human health and development of biotherapeutics. Biologics 5, 1–86 (2011)Google Scholar
  11. 11.
    J.P. Nolan, The role of intestinal endotoxin in liver injury: a long and evolving history. Hepatology 52, 1829–1835 (2010)PubMedCrossRefGoogle Scholar
  12. 12.
    M.T. DeMeo, E.A. Mutlu, A. Keshavarzian et al., Intestinal permeation and gastrointestinal disease. J. Clin. Gastroenterol. 34, 385–396 (2002)PubMedCrossRefGoogle Scholar
  13. 13.
    A. Farhadi, S. Gundlapalli, M. Shaikh et al., Susceptibility to gut leakiness: a possible mechanism for endotoxaemia in non-alcoholic steatohepatitis. Liver Int. 28, 1026–1033 (2008)PubMedCrossRefGoogle Scholar
  14. 14.
    T.H. Frazier, J.K. DiBaise, C.J. McClain, Gut microbiota, intestinal permeability, obesity-induced inflammation, and liver injury. JPEN J. Parenter. Enteral. Nutr. 35(5 Suppl), 14S–20S (2011)PubMedCrossRefGoogle Scholar
  15. 15.
    P. Brun, I. Castagliuolo, V. Di Leo et al., Increased intestinal permeability in obese mice: new evidence in the pathogenesis of nonalcoholic steatohepatitis. Am. J. Physiol. Gastrointest. Liver Physiol. 292, G518–G525 (2007)PubMedCrossRefGoogle Scholar
  16. 16.
    L. Abenavoli, V. Arena, F. Giancotti et al., Celiac disease, primary biliary cirrhosis and helicobacter pylori infection: one link for three diseases. Int. J. Immunopathol. Pharmacol. 23, 1261–1265 (2010)PubMedGoogle Scholar
  17. 17.
    I.R. Korponay-Szabo, T. Halttunen, Z. Szalai et al., In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies. Gut 53, 641–648 (2004)PubMedCrossRefGoogle Scholar
  18. 18.
    M.T. Bardella, L. Valenti, C. Pagliari et al., Searching for coeliac disease in patients with non-alcoholic fatty liver disease. Dig. Liver Dis. 36, 333–336 (2004)PubMedCrossRefGoogle Scholar
  19. 19.
    L. Miele, V. Valenza, G. La Torre et al., Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease. Hepatology 49, 1877–1887 (2009)PubMedCrossRefGoogle Scholar
  20. 20.
    A.J. Wigg, I.C. Roberts-Thomson, R.B. Dymock et al., The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis. Gut 48, 206–211 (2001)PubMedCrossRefGoogle Scholar
  21. 21.
    A.J. Wigg, A.G. Cummins, Reply to Grieco et al. Gut. 49, 596 (2001)Google Scholar
  22. 22.
    A. Grieco, L. Miele, G. Pignatoro et al., Is coeliac disease a confounding factor in the diagnosis of NASH? Gut 49, 596 (2001)PubMedCrossRefGoogle Scholar
  23. 23.
    V. Nehra, P. Angulo, A.L. Buchman et al., Nutritional and metabolic considerations in the etiology of nonalcoholic steatohepatitis. Dig. Dis. Sci. 46, 2347–2352 (2001)PubMedCrossRefGoogle Scholar
  24. 24.
    O. Loiacono, S. Petta, G. Venezia et al., Anti-tissue transglutaminase antibodies in patients with abnormal liver test: is it always celiac disease? Am. J. Gastroenterol. 100, 2472–2477 (2005)CrossRefGoogle Scholar
  25. 25.
    A.R. Rahimi, N.E. Daryani, H. Ghofrani et al., The prevalence of celiac disease among patients with non-alcoholic fatty liver disease in Iran. Turk. J. Gastroenterol. 22, 300–304 (2011)PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ludovico Abenavoli
    • 1
    Email author
  • Natasa Milic
    • 2
  • Antonino De Lorenzo
    • 3
  • Francesco Luzza
    • 1
  1. 1.Department of Health SciencesUniversity “Magna Græcia”CatanzaroItaly
  2. 2.Department of PharmacyUniversity of Novi SadNovi SadSerbia
  3. 3.Department of Neuroscience, Division of Human NutritionUniversity “Tor Vergata”RomeItaly

Personalised recommendations