Entry Name Non-alcoholic fatty liver disease
Description Non-alcoholic fatty liver disease (NAFLD) represents a spectrum ranging from simple steatosis to more severe steatohepatitis with hepatic inflammation and fibrosis, known as nonalcoholic steatohepatitis (NASH). NASH may further lead to cirrhosis and hepatocellular carcinoma (HCC). This map shows a stage-dependent progression of NAFLD. In the first stage of NAFLD, excess lipid accumulation has been demonstrated. The main cause is the induction of insulin resistance, which leads to a defect in insulin suppression of free fatty acids (FAAs) disposal. In addition, two transcription factors, SREBP-1c and PPAR-alpha, activate key enzymes of lipogenesis and increase the synthesis of FAAs in liver. In the second stage, as a consequence of the progression to NASH, the production of reactive oxygen species (ROS) is enhanced due to oxidation stress through mitochondrial beta-oxidation of fatty acids and endoplamic reticulum (ER) stress, leading to lipid peroxidation. The lipid peroxidation can further cause the production of cytokines (Fas ligand, TNF-alpha, IL-8 and TGF), promoting cell death, inflammation and fibrosis. The activation of JNK, which is induced by ER stress, TNF-alpha and FAAs, is also associated with NAFLD progression. Increased JNK promotes cytokine production and initiation of HCC.
Class Human Diseases; Endocrine and metabolic diseaseBRITE hierarchy
Pathway map ko04932 Non-alcoholic fatty liver disease
Ortholog table Disease H01333 Non-alcoholic fatty liver disease
Orthology K04696 suppressor of cytokine signaling 3
K03156 tumor necrosis factor superfamily, member 2
K03158 tumor necrosis factor receptor superfamily member 1A
K02580 nuclear factor NF-kappa-B p105 subunit
K04735 transcription factor p65
K16172 insulin receptor substrate 1
K07187 insulin receptor substrate 2
K00922 phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha/beta/delta [EC:2.7.1.153 ]
K02649 phosphoinositide-3-kinase regulatory subunit alpha/beta/delta
K08524 retinoid X receptor alpha
K07197 sterol regulatory element-binding transcription factor 1
K07198 5'-AMP-activated protein kinase, catalytic alpha subunit [EC:2.7.11.31 ]
K07199 5'-AMP-activated protein kinase, regulatory beta subunit
K07200 5'-AMP-activated protein kinase, regulatory gamma subunit
K07294 peroxisome proliferator-activated receptor alpha
K08530 peroxisome proliferator-activated receptor gamma
K04393 cell division control protein 42
K04392 Ras-related C3 botulinum toxin substrate 1
K04440 mitogen-activated protein kinase 8/9/10 (c-Jun N-terminal kinase) [EC:2.7.11.24 ]
K08852 serine/threonine-protein kinase/endoribonuclease IRE1 [EC:2.7.11.1 3.1.26.-]
K04379 proto-oncogene protein c-fos
K04448 transcription factor AP-1
K07209 inhibitor of nuclear factor kappa-B kinase subunit beta [EC:2.7.11.10 ]
K09027 X box-binding protein 1
K09055 CCAAT/enhancer binding protein (C/EBP), alpha
K07415 cytochrome P450 family 2 subfamily E1 [EC:1.14.14.-]
K04389 tumor necrosis factor ligand superfamily member 6
K13375 transforming growth factor beta-1
K08860 eukaryotic translation initiation factor 2-alpha kinase 3 [EC:2.7.11.1 ]
K03237 translation initiation factor 2 subunit 1
K04374 cyclic AMP-dependent transcription factor ATF-4
K04452 DNA damage-inducible transcript 3
K02159 apoptosis regulator BAX
K04390 tumor necrosis factor receptor superfamily member 6
K04726 BH3 interacting domain death agonist
K03942 NADH dehydrogenase (ubiquinone) flavoprotein 1 [EC:7.1.1.2 ]
K03943 NADH dehydrogenase (ubiquinone) flavoprotein 2 [EC:7.1.1.2 ]
K03944 NADH dehydrogenase (ubiquinone) flavoprotein 3
K03945 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 1
K03946 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 2
K03947 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 3
K03948 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 4
K03949 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 5
K03950 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 6
K03951 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 7
K03952 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 8
K03953 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 9
K03954 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 10
K03955 NADH dehydrogenase (ubiquinone) 1 alpha/beta subcomplex 1, acyl-carrier protein
K03956 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 11
K11352 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 12
K11353 NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 13
K03957 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 1
K03958 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 2
K03959 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 3
K03960 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 4
K03961 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 5
K03962 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 6
K03963 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 7
K03964 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 8
K03965 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 9
K03966 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 10
K11351 NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 11
K03934 NADH dehydrogenase (ubiquinone) Fe-S protein 1 [EC:7.1.1.2 ]
K03935 NADH dehydrogenase (ubiquinone) Fe-S protein 2 [EC:7.1.1.2 ]
K03936 NADH dehydrogenase (ubiquinone) Fe-S protein 3 [EC:7.1.1.2 ]
K03937 NADH dehydrogenase (ubiquinone) Fe-S protein 4
K03938 NADH dehydrogenase (ubiquinone) Fe-S protein 5
K03939 NADH dehydrogenase (ubiquinone) Fe-S protein 6
K03940 NADH dehydrogenase (ubiquinone) Fe-S protein 7 [EC:7.1.1.2 ]
K03941 NADH dehydrogenase (ubiquinone) Fe-S protein 8 [EC:7.1.1.2 ]
K03967 NADH dehydrogenase (ubiquinone) 1 subunit C1
K03968 NADH dehydrogenase (ubiquinone) 1 subunit C2
K00234 succinate dehydrogenase (ubiquinone) flavoprotein subunit [EC:1.3.5.1 ]
K00235 succinate dehydrogenase (ubiquinone) iron-sulfur subunit [EC:1.3.5.1 ]
K00236 succinate dehydrogenase (ubiquinone) cytochrome b560 subunit
K00237 succinate dehydrogenase (ubiquinone) membrane anchor subunit
K00411 ubiquinol-cytochrome c reductase iron-sulfur subunit [EC:7.1.1.8 ]
K00412 ubiquinol-cytochrome c reductase cytochrome b subunit
K00413 ubiquinol-cytochrome c reductase cytochrome c1 subunit
K00414 ubiquinol-cytochrome c reductase core subunit 1
K00415 ubiquinol-cytochrome c reductase core subunit 2
K00416 ubiquinol-cytochrome c reductase subunit 6
K00417 ubiquinol-cytochrome c reductase subunit 7
K00418 ubiquinol-cytochrome c reductase subunit 8
K00419 ubiquinol-cytochrome c reductase subunit 9
K00420 ubiquinol-cytochrome c reductase subunit 10
K02262 cytochrome c oxidase subunit 3
K02261 cytochrome c oxidase subunit 2
K02263 cytochrome c oxidase subunit 4
K02264 cytochrome c oxidase subunit 5a
K02265 cytochrome c oxidase subunit 5b
K02266 cytochrome c oxidase subunit 6a
K02267 cytochrome c oxidase subunit 6b
K02268 cytochrome c oxidase subunit 6c
K02270 cytochrome c oxidase subunit 7a
K02271 cytochrome c oxidase subunit 7b
K02272 cytochrome c oxidase subunit 7c
K02273 cytochrome c oxidase subunit 8
Compound Reference Authors Naik A, Kosir R, Rozman D
Title Genomic aspects of NAFLD pathogenesis.
Journal Reference Authors Malaguarnera M, Di Rosa M, Nicoletti F, Malaguarnera L
Title Molecular mechanisms involved in NAFLD progression.
Journal Reference Authors Seki E, Brenner DA, Karin M
Title A liver full of JNK: signaling in regulation of cell function and disease pathogenesis, and clinical approaches.
Journal Reference Authors Tilg H, Moschen AR
Title Evolution of inflammation in nonalcoholic fatty liver disease: the multiple parallel hits hypothesis.
Journal Reference Authors Larter CZ, Farrell GC
Title Insulin resistance, adiponectin, cytokines in NASH: Which is the best target to treat?
Journal Reference Authors Farrell GC, van Rooyen D, Gan L, Chitturi S
Title NASH is an Inflammatory Disorder: Pathogenic, Prognostic and Therapeutic Implications.
Journal Reference Authors Shapiro H, Tehilla M, Attal-Singer J, Bruck R, Luzzatti R, Singer P
Title The therapeutic potential of long-chain omega-3 fatty acids in nonalcoholic fatty liver disease.
Journal Reference Authors Hotamisligil GS
Title Endoplasmic reticulum stress and the inflammatory basis of metabolic disease.
Journal Reference Authors Parekh S, Anania FA
Title Abnormal lipid and glucose metabolism in obesity: implications for nonalcoholic fatty liver disease.
Journal Reference Authors Schattenberg JM, Singh R, Wang Y, Lefkowitch JH, Rigoli RM, Scherer PE, Czaja MJ
Title JNK1 but not JNK2 promotes the development of steatohepatitis in mice.
Journal Reference Authors Leung TM, Nieto N
Title CYP2E1 and oxidant stress in alcoholic and non-alcoholic fatty liver disease.
Journal Reference Authors Zafrani ES
Title Non-alcoholic fatty liver disease: an emerging pathological spectrum.
Journal Reference Authors Feldstein AE, Canbay A, Angulo P, Taniai M, Burgart LJ, Lindor KD, Gores GJ
Title Hepatocyte apoptosis and fas expression are prominent features of human nonalcoholic steatohepatitis.
Journal Reference Authors Begriche K, Igoudjil A, Pessayre D, Fromenty B
Title Mitochondrial dysfunction in NASH: causes, consequences and possible means to prevent it.
Journal Reference Authors Leonarduzzi G, Scavazza A, Biasi F, Chiarpotto E, Camandola S, Vogel S, Dargel R, Poli G
Title The lipid peroxidation end product 4-hydroxy-2,3-nonenal up-regulates transforming growth factor beta1 expression in the macrophage lineage: a link between oxidative injury and fibrosclerosis.
Journal Reference Authors Malhi H, Kaufman RJ
Title Endoplasmic reticulum stress in liver disease.
Journal Reference Authors Mantena SK, King AL, Andringa KK, Eccleston HB, Bailey SM
Title Mitochondrial dysfunction and oxidative stress in the pathogenesis of alcohol- and obesity-induced fatty liver diseases.
Journal Reference Authors Serviddio G, Sastre J, Bellanti F, Vina J, Vendemiale G, Altomare E
Title Mitochondrial involvement in non-alcoholic steatohepatitis.
Journal Reference Authors Begriche K, Massart J, Robin MA, Bonnet F, Fromenty B
Title Mitochondrial adaptations and dysfunctions in nonalcoholic fatty liver disease.
Journal Related ko04141 Protein processing in endoplasmic reticulum
ko04920 Adipocytokine signaling pathway
LinkDB All DBs
