Authors:János Fehér, László Váli, Anna Blázovics, and Gabriella Lengyel
Hepatic steatosis involves an imbalance between the processes of the hepatocytes’ lipid uptake and lipid elimination, an overproduction results in the accumulation of excess triglycerides in the cells of the liver. Normally about 5% of the cells contain triglyceride; in steatosis this may exceed 50%. Under 50% the condition is called fatty infiltration, and over 50% it is called fatty liver. In mild forms this does not necessarily lead to disorders in cell functions, but in more severe forms it does; it often precedes the death of the cell. Fatty liver can be considered a pathologic condition which makes the liver more susceptible to other toxic influences. It is not a genuine disease; in most cases it is associated with a noxious state or other pathologic process. Alcohol-induced fatty liver is a current epidemie. The abnormal accumulation of fat in parenchymal organs, including the liver, is called fatty transformation or steatosis. Alone and limited to a certain degree of severity (the appearance of fibrosis), it represents a reversible damage; upon cessation of the underlying cause the liver clears its excess triglyceride content. The treatment is to be aimed at the underlying process; up to now there is no known specific medicine that could clearly reduce the fat accumulated in the hepatocytes. Although the etiologic factors of these diseases differ from each other, the pathological changes in the liver are very similar, thus certain drugs could be equally effective for treating them both. Metadoxine is one of those drugs, mainly due to its liver-protective effect against damage from free radicals. As an effective antioxidant, metadoxine regulates glutathione levels in the liver and throughout the body, thus positively influencing the maintenance of systemic redox homeostasis. The authors discuss in detail the effect of metadoxine in the treatment of fatty liver diseases (alcoholic and non-alcoholic), they also review the effect of metadoxine in both in vitro and in vivo experimental conditions.