Is telmisartan effective in treating non-alcoholic steatohepatitis?
Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are well-recognized causes of progressive liver disease leading to cirrhosis and hepatocellular carcinoma. To date, no therapy provided evidence of significant efficacy in these conditions and no approved therapeutic options are available worldwide. As the renin-angiotensin system overexpression plays a central role in insulin resistance and subsequently in NAFLD/NASH as the hepatic expression of metabolic syndrome, an attempt to block its deleterious effects and thus to improve insulin sensitivity and to antagonize the local hepatic effects of a vicious cycle seems logically correct. In the light of this, angiotensin receptor blockers (ARBs) could act as an elegant tool for adequate correction of various imbalances that act in concert in NASH/NAFLD. Indeed, by inhibiting the renin-angiotensin system, the intracellular insulin signaling pathways can be improved, adipose tissue proliferation and adipokine
