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Published Online First: 2 July 2008. doi:10.1136/gut.2007.144550
Gut 2008;57:1583-1591
Copyright © 2008 BMJ Publishing Group Ltd & British Society of Gastroenterology.

Hepatology

Effectiveness of antiplatelet drugs against experimental non-alcoholic fatty liver disease

K Fujita1, Y Nozaki1, K Wada2, M Yoneda1, H Endo1, H Takahashi1, T Iwasaki3, M Inamori1, Y Abe1, N Kobayashi1, H Kirikoshi1, K Kubota1, S Saito1, Y Nagashima4, A Nakajima1

1 Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Kanazawa-ku, Yokohama, Japan
2 Department of Pharmacology, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan
3 Division of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Kanazawa-ku, Yokohama, Japan
4 Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Kanazawa-ku, Yokohama, Japan

Dr A Nakajima, Division of Gastroenterology, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan; nakajima-tky{at}umin.ac.jp

Objective: No effective drugs have been developed to date to prevent or treat non-alcoholic fatty liver disease (NAFLD), although diet modification and exercise to improve obesity have been attempted. Therefore, development of a novel drug/strategy to treat NAFLD is urgently needed. In the present study, a novel concept is proposed for the treatment of NAFLD.

Methods: Fisher 344 male rats were given a choline-deficient, L-amino acid-defined (CDAA) diet or a high-fat high-calorie (HF/HC) diet with or without the antiplatelet agents, aspirin, ticlopidine or cilostazol for 16 weeks. Liver steatosis, inflammation and fibrosis, and the possible mechanisms involved were investigated.

Results: All three antiplatelet drugs, namely aspirin, ticlopidine and cilostazol, significantly attenuated liver steatosis, inflammation and fibrosis in the CDAA diet group. Of the three agents, cilostazol was the most effective, and the drug also suppressed HF/HC diet-induced liver steatosis. Cilostazol appeared to exert its beneficial effect against NAFLD by suppressing mitogen-activated protein kinase activation induced by oxidative stress and platelet-derived growth factor via intercepting signal transduction from Akt to c-Raf.

Conclusion: Antiplatelet agents, especially cilostazol, offer the promise of becoming key agents for the treatment of NAFLD.


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