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New Paradigms in the Histopathology of NAFLD

  • Fatty Liver Disease (SA Harrison and J George, Section editors)
  • Published:
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Abstract

Non-alcoholic fatty liver disease (NAFLD) is a rapidly growing global health problem. It can be separated histologically into two broad groups: steatosis, which usually follows a benign clinical course and non-alcoholic steatohepatitis (NASH) that typically has hepatocyte ballooning, necroinflammatory activity and can progress to fibrosis and cirrhosis. More recently the histological spectrum has expanded with the recognition of a paediatric pattern of NASH that has portal-based inflammation and fibrosis without ballooning. An overlap pattern is also described. There is increasing interest in the portal changes of NASH as these correlate with the progression of fibrosis. Disease-associated hepatocyte senescence appears to trigger an alternative regenerative pathway and the development of a periportal ductular reaction (DR), which in turn may have a role in progressive fibrogenesis. Portal inflammation, particularly in association with the DR, is an area of recent study.

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Abbreviations

CRN-NAS:

NASH Clinical Research Network NAFLD Activity Score

DR:

ductular reaction

HPC:

hepatic progenitor cell

MMP:

matrix metalloproteinase

NAFLD:

non-alcoholic fatty liver disease

NASH:

non-alcoholic steatohepatitis

References

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Acknowledgments

This work was supported by grants from the National Health and Medical Research Council of Australia and The Princess Alexandra Hospital Foundation.

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Conflict of Interest

Andrew D. Clouston, Victoria L. Gadd, Katharine Irvine, and Elizabeth E. Powell declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

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Authors and Affiliations

  1. Centre for Liver Disease Research, School of Medicine, The University of Queensland, Translational Research Institute, Brisbane, Australia

    Andrew D. Clouston, Victoria L. Gadd, Katharine M. Irvine & Elizabeth E. Powell

  2. Envoi Specialist Pathologists, 5/38 Bishop St, Kelvin Grove, Brisbane, Australia

    Andrew D. Clouston

  3. Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia

    Elizabeth E. Powell

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  1. Andrew D. Clouston
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Correspondence to Andrew D. Clouston.

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Clouston, A.D., Gadd, V.L., Irvine, K.M. et al. New Paradigms in the Histopathology of NAFLD. Curr Hepatology Rep 13, 81–87 (2014). https://doi.org/10.1007/s11901-014-0214-x

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