Role of oxidative stress in the pathogenesis of nonalcoholic steatohepatitis

► NASH pathogenesis is widely recognized as a two-hit model. ► The “first hit” is an initial metabolic disturbance increasing inflow of free fats. ► The “second hit” includes oxidative stress, decreased hepatic ATP and inflammation. ► Impaired mitochondrial bioenergetics, function and morphology are observed.