Entry
Name
Non-alcoholic fatty liver disease - Homo sapiens (human)
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 disease
BRITE hierarchy
Pathway map
hsa04932 Non-alcoholic fatty liver disease
Disease
H01333 Metabolic dysfunction-associated steatotic liver disease; Non-alcoholic fatty liver disease
Drug
D10988 Selonsertib (JAN/USAN/INN)
D11257 Seladelpar lysine (USAN)
D13044 Saroglitazar (USAN/INN)
D13045 Saroglitazar magnesium (USAN)
D13335 Lanifibranor (USAN/INN)
Organism
Homo sapiens (human) [GN:
hsa ]
Gene
10018 BCL2L11; bcl-2-like protein 11 isoform 1 [KO:K16341 ]
100532726 NDUFC2-KCTD14; NADH dehydrogenase [ubiquinone] 1 subunit C2, isoform 2 isoform 2 [KO:K03968 ]
10062 NR1H3; oxysterols receptor LXR-alpha isoform 1 [KO:K08536 ]
1050 CEBPA; CCAAT/enhancer-binding protein alpha isoform a [KO:K09055 ]
10975 UQCR11; cytochrome b-c1 complex subunit 10 [KO:K00420 ]
126328 NDUFA11; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 11 isoform 1 [KO:K03956 ]
1327 COX4I1; cytochrome c oxidase subunit 4 isoform 1, mitochondrial isoform 1 precursor [KO:K02263 ]
1329 COX5B; cytochrome c oxidase subunit 5B, mitochondrial precursor [KO:K02265 ]
1337 COX6A1; cytochrome c oxidase subunit 6A1, mitochondrial [KO:K02266 ]
1339 COX6A2; cytochrome c oxidase subunit 6A2, mitochondrial precursor [KO:K02266 ]
1340 COX6B1; cytochrome c oxidase subunit 6B1 [KO:K02267 ]
1345 COX6C; cytochrome c oxidase subunit 6C [KO:K02268 ]
1346 COX7A1; cytochrome c oxidase subunit 7A1, mitochondrial precursor [KO:K02270 ]
1347 COX7A2; cytochrome c oxidase subunit 7A2, mitochondrial [KO:K02270 ]
1349 COX7B; cytochrome c oxidase subunit 7B, mitochondrial precursor [KO:K02271 ]
1350 COX7C; cytochrome c oxidase subunit 7C, mitochondrial precursor [KO:K02272 ]
1351 COX8A; cytochrome c oxidase subunit 8A, mitochondrial [KO:K02273 ]
1537 CYC1; cytochrome c1, heme protein, mitochondrial precursor [KO:K00413 ]
1571 CYP2E1; cytochrome P450 2E1 [KO:K07415 ] [EC:1.14.14.-]
1649 DDIT3; DNA damage-inducible transcript 3 protein isoform 2 [KO:K04452 ]
170712 COX7B2; cytochrome c oxidase subunit 7B2, mitochondrial precursor [KO:K02271 ]
1965 EIF2S1; eukaryotic translation initiation factor 2 subunit 1 [KO:K03237 ]
208 AKT2; RAC-beta serine/threonine-protein kinase isoform 1 [KO:K04456 ] [EC:2.7.11.1 ]
2081 ERN1; serine/threonine-protein kinase/endoribonuclease IRE1 precursor [KO:K08852 ] [EC:2.7.11.1 3.1.26.-]
27089 UQCRQ; cytochrome b-c1 complex subunit 8 [KO:K00418 ]
29796 UQCR10; cytochrome b-c1 complex subunit 9 isoform a [KO:K00419 ]
341947 COX8C; cytochrome c oxidase subunit 8C, mitochondrial [KO:K02273 ]
355 FAS; tumor necrosis factor receptor superfamily member 6 isoform 1 precursor [KO:K04390 ]
3551 IKBKB; inhibitor of nuclear factor kappa-B kinase subunit beta isoform 1 [KO:K07209 ] [EC:2.7.11.10 ]
3552 IL1A; interleukin-1 alpha precursor [KO:K04383 ]
3553 IL1B; interleukin-1 beta proprotein [KO:K04519 ]
356 FASLG; tumor necrosis factor ligand superfamily member 6 isoform 1 [KO:K04389 ]
3569 IL6; interleukin-6 isoform 1 precursor [KO:K05405 ]
3570 IL6R; interleukin-6 receptor subunit alpha isoform 1 precursor [KO:K05055 ]
3576 CXCL8; interleukin-8 isoform 1 precursor [KO:K10030 ]
3667 IRS1; insulin receptor substrate 1 [KO:K16172 ]
374291 NDUFS7; NADH dehydrogenase [ubiquinone] iron-sulfur protein 7, mitochondrial isoform 1 [KO:K03940 ] [EC:7.1.1.2 ]
3953 LEPR; leptin receptor isoform 1 precursor [KO:K05062 ]
4217 MAP3K5; mitogen-activated protein kinase kinase kinase 5 isoform 2 [KO:K04426 ] [EC:2.7.11.25 ]
440567 UQCRHL; cytochrome b-c1 complex subunit 6-like, mitochondrial [KO:K00416 ]
4513 COX2; cytochrome c oxidase subunit II [KO:K02261 ]
4514 COX3; cytochrome c oxidase subunit III [KO:K02262 ]
468 ATF4; cyclic AMP-dependent transcription factor ATF-4 [KO:K04374 ]
4694 NDUFA1; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 1 [KO:K03945 ]
4695 NDUFA2; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 2 isoform 1 [KO:K03946 ]
4696 NDUFA3; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 3 [KO:K03947 ]
4697 COXFA4; cytochrome c oxidase subunit NDUFA4 [KO:K03948 ]
4698 NDUFA5; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 5 isoform 1 [KO:K03949 ]
4700 NDUFA6; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 6 [KO:K03950 ]
4701 NDUFA7; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 7 [KO:K03951 ]
4702 NDUFA8; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 8 isoform 1 [KO:K03952 ]
4704 NDUFA9; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 9, mitochondrial precursor [KO:K03953 ]
4705 NDUFA10; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 10, mitochondrial isoform 1 precursor [KO:K03954 ]
4706 NDUFAB1; acyl carrier protein, mitochondrial precursor [KO:K03955 ]
4707 NDUFB1; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 1 [KO:K03957 ]
4708 NDUFB2; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 2, mitochondrial precursor [KO:K03958 ]
4709 NDUFB3; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 3 [KO:K03959 ]
4710 NDUFB4; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 4 isoform 1 [KO:K03960 ]
4711 NDUFB5; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 5, mitochondrial isoform 1 precursor [KO:K03961 ]
4712 NDUFB6; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 6 isoform 1 [KO:K03962 ]
4713 NDUFB7; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 7 [KO:K03963 ]
4714 NDUFB8; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 8, mitochondrial isoform 1 precursor [KO:K03964 ]
4715 NDUFB9; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 9 isoform 1 [KO:K03965 ]
4716 NDUFB10; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 10 [KO:K03966 ]
4717 NDUFC1; NADH dehydrogenase [ubiquinone] 1 subunit C1, mitochondrial precursor [KO:K03967 ]
4718 NDUFC2; NADH dehydrogenase [ubiquinone] 1 subunit C2 isoform 1 [KO:K03968 ]
4719 NDUFS1; NADH-ubiquinone oxidoreductase 75 kDa subunit, mitochondrial isoform 1 precursor [KO:K03934 ] [EC:7.1.1.2 ]
4720 NDUFS2; NADH dehydrogenase [ubiquinone] iron-sulfur protein 2, mitochondrial isoform 1 precursor [KO:K03935 ] [EC:7.1.1.2 ]
4722 NDUFS3; NADH dehydrogenase [ubiquinone] iron-sulfur protein 3, mitochondrial precursor [KO:K03936 ] [EC:7.1.1.2 ]
4723 NDUFV1; NADH dehydrogenase [ubiquinone] flavoprotein 1, mitochondrial isoform 1 precursor [KO:K03942 ] [EC:7.1.1.2 ]
4724 NDUFS4; NADH dehydrogenase [ubiquinone] iron-sulfur protein 4, mitochondrial isoform 1 precursor [KO:K03937 ]
4725 NDUFS5; NADH dehydrogenase [ubiquinone] iron-sulfur protein 5 [KO:K03938 ]
4726 NDUFS6; NADH dehydrogenase [ubiquinone] iron-sulfur protein 6, mitochondrial precursor [KO:K03939 ]
4728 NDUFS8; NADH dehydrogenase [ubiquinone] iron-sulfur protein 8, mitochondrial precursor [KO:K03941 ] [EC:7.1.1.2 ]
4729 NDUFV2; NADH dehydrogenase [ubiquinone] flavoprotein 2, mitochondrial precursor [KO:K03943 ] [EC:7.1.1.2 ]
4731 NDUFV3; NADH dehydrogenase [ubiquinone] flavoprotein 3, mitochondrial isoform b precursor [KO:K03944 ]
4790 NFKB1; nuclear factor NF-kappa-B p105 subunit isoform 2 proprotein [KO:K02580 ]
51079 NDUFA13; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 13 [KO:K11353 ]
51085 MLXIPL; carbohydrate-responsive element-binding protein isoform alpha [KO:K09113 ]
51094 ADIPOR1; adiponectin receptor protein 1 [KO:K07297 ]
51422 PRKAG2; 5'-AMP-activated protein kinase subunit gamma-2 isoform a [KO:K07200 ]
5290 PIK3CA; phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha isoform [KO:K00922 ] [EC:2.7.1.153 ]
5291 PIK3CB; phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit beta isoform isoform 1 [KO:K00922 ] [EC:2.7.1.153 ]
5293 PIK3CD; phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit delta isoform isoform 1 [KO:K00922 ] [EC:2.7.1.153 ]
5295 PIK3R1; phosphatidylinositol 3-kinase regulatory subunit alpha isoform 1 [KO:K02649 ]
5296 PIK3R2; phosphatidylinositol 3-kinase regulatory subunit beta [KO:K02649 ]
53632 PRKAG3; 5'-AMP-activated protein kinase subunit gamma-3 [KO:K07200 ]
54539 NDUFB11; NADH dehydrogenase [ubiquinone] 1 beta subcomplex subunit 11, mitochondrial isoform 2 [KO:K11351 ]
5465 PPARA; peroxisome proliferator-activated receptor alpha isoform 1 [KO:K07294 ]
5468 PPARG; peroxisome proliferator-activated receptor gamma isoform 2 [KO:K08530 ]
5562 PRKAA1; 5'-AMP-activated protein kinase catalytic subunit alpha-1 isoform 1 [KO:K07198 ] [EC:2.7.11.31 ]
5563 PRKAA2; 5'-AMP-activated protein kinase catalytic subunit alpha-2 [KO:K07198 ] [EC:2.7.11.31 ]
5564 PRKAB1; 5'-AMP-activated protein kinase subunit beta-1 [KO:K07199 ]
5565 PRKAB2; 5'-AMP-activated protein kinase subunit beta-2 [KO:K07199 ]
5571 PRKAG1; 5'-AMP-activated protein kinase subunit gamma-1 isoform 1 [KO:K07200 ]
55967 NDUFA12; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 12 isoform a [KO:K11352 ]
56901 COXFA4L2; NADH dehydrogenase [ubiquinone] 1 alpha subcomplex subunit 4-like 2 [KO:K03948 ]
581 BAX; apoptosis regulator BAX isoform alpha [KO:K02159 ]
5879 RAC1; ras-related C3 botulinum toxin substrate 1 isoform Rac1 [KO:K04392 ]
5970 RELA; transcription factor p65 isoform 1 [KO:K04735 ]
6256 RXRA; retinoic acid receptor RXR-alpha isoform a [KO:K08524 ]
637 BID; BH3-interacting domain death agonist isoform 2 [KO:K04726 ]
6389 SDHA; succinate dehydrogenase [ubiquinone] flavoprotein subunit, mitochondrial isoform 1 [KO:K00234 ] [EC:1.3.5.1 ]
6390 SDHB; succinate dehydrogenase [ubiquinone] iron-sulfur subunit, mitochondrial isoform 1 precursor [KO:K00235 ] [EC:1.3.5.1 ]
6391 SDHC; succinate dehydrogenase cytochrome b560 subunit, mitochondrial isoform 1 precursor [KO:K00236 ]
6392 SDHD; succinate dehydrogenase [ubiquinone] cytochrome b small subunit, mitochondrial isoform a precursor [KO:K00237 ]
6720 SREBF1; sterol regulatory element-binding protein 1 isoform 2 [KO:K07197 ]
6945 MLX; max-like protein X isoform gamma [KO:K09113 ]
7040 TGFB1; transforming growth factor beta-1 proprotein preproprotein [KO:K13375 ]
7132 TNFRSF1A; tumor necrosis factor receptor superfamily member 1A isoform 1 precursor [KO:K03158 ]
7381 UQCRB; cytochrome b-c1 complex subunit 7 isoform 1 [KO:K00417 ]
7384 UQCRC1; cytochrome b-c1 complex subunit 1, mitochondrial precursor [KO:K00414 ]
7385 UQCRC2; cytochrome b-c1 complex subunit 2, mitochondrial precursor [KO:K00415 ]
7386 UQCRFS1; cytochrome b-c1 complex subunit Rieske, mitochondrial [KO:K00411 ] [EC:7.1.1.8 ]
7388 UQCRH; cytochrome b-c1 complex subunit 6, mitochondrial isoform 1 precursor [KO:K00416 ]
7494 XBP1; X-box-binding protein 1 isoform XBP1(U) [KO:K09027 ]
79602 ADIPOR2; adiponectin receptor protein 2 isoform 2 [KO:K07297 ]
84701 COX4I2; cytochrome c oxidase subunit 4 isoform 2, mitochondrial [KO:K02263 ]
8503 PIK3R3; phosphatidylinositol 3-kinase regulatory subunit gamma isoform 1 [KO:K02649 ]
8660 IRS2; insulin receptor substrate 2 [KO:K07187 ]
9021 SOCS3; suppressor of cytokine signaling 3 [KO:K04696 ]
9167 COX7A2L; cytochrome c oxidase subunit 7A2-like, mitochondrial isoform a [KO:K02270 ]
9377 COX5A; cytochrome c oxidase subunit 5A, mitochondrial precursor [KO:K02264 ]
9451 EIF2AK3; eukaryotic translation initiation factor 2-alpha kinase 3 isoform 1 precursor [KO:K08860 ] [EC:2.7.11.1 ]
998 CDC42; cell division control protein 42 homolog isoform 1 precursor [KO:K04393 ]
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 pathway
hsa04141 Protein processing in endoplasmic reticulum
hsa04920 Adipocytokine signaling pathway
KO pathway