Rôles de l'intestin et du foie dans la progression de la stéatopathie métabolique et sa modulation par les acides gras polyinsaturés à longue chaîne n-3

Nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH) increases the risk for fibrosis, cirrhosis, and hepatocellular carcinoma. The mechanisms underlying the steatosis to NASH transition remain incompletely understood despite recent progress in cellular and molecular aspects. The aims of this review were: to analyze recent advances in understanding of the alterations of liver fat metabolism and the implication of gut physiology and microbiota in this transition; to gather experimental and clinical data on the ability of long chain n-3 PUFA (LC n-3 PUFA) to prevent or alleviate NAFL. Increasing data support a pivotal role for the gut towards NASH development and LC n-3 PUFA have often proven preventive or therapeutic effect towards NASH in rodents. In humans, they prevent or reduce steatosis, but have no therapeutic effect on NASH. However, they could have preventive effects, which require defining better the specific roles, modes of action and doses of DHA vs EPA.