NAFLD is a terribly common condition that involves fat build-up in the liver and affects an estimated 25% of the world population and nearly half of Singapore. Untreated NAFLD will progress into cirrhosis (which can be life-threatening) or other advanced liver conditions and is the leading cause of liver transplants in the world.
When NAFLD progresses to the point where it causes inflammation and liver scarring, this is known as non-alcoholic steatohepatitis (NASH). “While fat deposition in the liver is reversible in its early stages, its progression to NASH causes liver dysfunction, cirrhosis and increases the risk for liver cancer,” said Dr. Madhulika Tripathi, one of the study authors to Science Daily.
The reason why this happens remains unclear. Hence, there are no medical treatments for curing the disease. That being said, medical researchers have known for some time that patients suffering from non-alcoholic steatohepatitis also often have elevated blood levels of homocysteine. The authors of the Duke-NUS Medical School study have posited that homocysteine plays a role in the development of NASH. The study was published in the Journal of Hepatology, and we examine them further.
The main argument of the research is that elevated homocysteine levels directly relate to the severity of non-alcoholic steatohepatitis. The researchers developed a model of how this occurs based on preclinical models and humans. They observed that homocysteine, an amino acid, can bind to proteins in the liver, alter their structure, and disrupt their functioning.
Particularly, when homocysteine binds to a protein named syntaxin 17, it renders the protein incapable of transporting and breaking down fat. The malformed proteins are unable to be repaired by natural restorative processes, and the liver becomes inflamed and increasingly incapable of digesting fats. As a result, NASH starts to develop and worsen over time.
But the research doesn't stop there. Having discovered the reason why homocysteine is harmful to the liver, the authors of the study also attempted to examine if reducing homocysteine levels could reverse or delay this severe form of fatty liver disease. And here’s where the vitamins B12 and B9 enter the picture…
Related Article: Reverse Fatty Liver Disease With Your Diet
In the human body, homocysteine is naturally broken down by vitamins B12 and folic acid into other essential nutrients. Naturally, the scientists decided to check if supplementing with these two vitamins made a difference in the progression of NASH. Long story short, this is exactly what happened: inflammation and scarring were reversed, and the progression of NASH slowed down considerably. On the cellular level, the functions of the syntaxin 17 protein in the liver had also restarted. As Dr. Brijesh Singh points out:
“Our findings are both exciting and important because they suggest that a relatively inexpensive therapy, vitamin B12, and folic acid, could be used to prevent and/or delay the progression of NASH.”
Currently, the only known treatment is a liver transplant. The potential of using vitamin B12 and folate to prevent and treat non-alcoholic fatty liver disease is truly groundbreaking. After all, this means that we already have an affordable treatment that can be directly implemented pretty much anywhere around the globe. If these findings are corroborated by other researchers in the future, this could save millions of people.
Last but not least, the authors also suggest that homocysteine could affect other proteins in a similar fashion, which is exactly what they set out to test in future experiments.
H/T: Science Daily
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