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Vitamin E in Nonalcoholic Fatty Liver Disease

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Vitamin E in Human Health

Part of the book series: Nutrition and Health ((NH))

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, accounting for over 100 billion dollars in annual direct medical costs in the United States alone. Nonalcoholic steatohepatitis (NASH) is a subtype of NAFLD that can progress to cirrhosis and liver cancer. To date, there are no approved pharmacological therapies for NASH. Vitamin E is an antioxidant that has been shown to improve the histological features of NASH in both preclinical and clinical studies. Several clinical practice guidelines recommend vitamin E as off-label treatment for NASH. Here, we discuss the complex pathogenesis of NASH, with emphasis on oxidative stress and organelle dysfunction. We summarize evidence supporting the beneficial role of vitamin E supplementation on NASH and on liver fibrosis, based on studies in animal models of NAFLD, in clinical trials of NAFLD patients and in meta-analyses. We briefly highlight the use of vitamin E in other forms of chronic liver disease, including alcoholic liver disease and chronic viral hepatitis, where the role of vitamin E supplementation remains controversial. Finally, we discuss safety concerns related to the long-term use of vitamin E and suggest that risks and benefits be discussed with patients prior to initiating vitamin E supplementation.

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Abbreviations

4-HNE:

4-Hydroxy-2-nonenal

8-OHdG:

8-Hydroxy-2′-deoxyguanosine

ALT:

Alanine aminotransferase

CRN:

Clinical Research Network

CYP2E1:

Cytochrome P450 2E1

ER:

Endoplasmic reticulum

FAD:

Flavin adenine dinucleotide

FFA:

Free fatty acids

GPx:

Glutathione peroxidase

GSH:

Glutathione

IR:

Insulin resistance

JNK:

Janus kinase

MCD:

Methionine-choline-deficient

MDA:

Malondialdehyde

MRC:

Mitochondrial respiratory complex

NAD:

Nicotinamide adenine dinucleotide

NAFL:

Nonalcoholic fatty liver

NAFLD:

Nonalcoholic fatty liver disease

NASH:

Nonalcoholic steatohepatitis

PIVENS:

Pioglitazone versus Vitamin E versus Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis

PPAR-α:

Peroxisome proliferator-activated receptor-α

PUFAs:

Polyunsaturated fatty acids

RCT:

Randomized control trial

ROS:

Reactive oxygen species

SELECT:

Selenium and Vitamin E Cancer Prevention Trial

SH3BP5:

SH3 domain-binding protein 5

TNF:

Tumor necrosis factor

TONIC:

Treatment of nonalcoholic fatty liver disease in Children

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA

    Bubu A. Banini & Arun J. Sanyal

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  1. Bubu A. Banini
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  2. Arun J. Sanyal
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Correspondence to Arun J. Sanyal .

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Editors and Affiliations

  1. University of Hohenheim, Institute of Nutritional Sciences, Stuttgart , Germany

    Peter Weber

  2. University of Applied Sciences Fulda, Nutritional, Food and Consumer Sciences, Fulda, Germany

    Marc Birringer

  3. Friedman School of Nutrition Science and Policy, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    Jeffrey B. Blumberg

  4. University Medical Center Groningen, Hanzeplain 1, Groningen, The Netherlands

    Manfred Eggersdorfer

  5. University of Hohenheim, Institute of Nutritional Sciences, Stuttgart , Germany

    Jan Frank

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Banini, B.A., Sanyal, A.J. (2019). Vitamin E in Nonalcoholic Fatty Liver Disease. In: Weber, P., Birringer, M., Blumberg, J., Eggersdorfer, M., Frank, J. (eds) Vitamin E in Human Health. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-030-05315-4_23

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