Reduced lysosomal acid lipase activity: A new marker of liver disease severity across the clinical continuum of non-alcoholic fatty liver disease?
Lysosomal acid lipase (LAL) plays a key role in intracellular lipid metabolism. Reduced LAL activity promotes increased multi-organ lysosomal cholesterol ester storage, as observed in two recessive autosomal genetic diseases, Wolman disease and Cholesterol ester storage disease. Severe liver steatosis and accelerated liver fibrosis are common features in patients with genetic LAL deficiency. By contrast, few reliable data are available on the modulation of LAL activity in vivo and on the epigenetic and metabolic factors capable of regulating its activity in subjects without homozygous mutations of the Lipase A gene. In the last few years, a less severe and non-genetic reduction of LAL activity was reported in children and adults with non-alcoholic fatty liver disease (NAFLD), suggesting a possible role of LAL reduction in the pathogenesis and progression of the disease. Patients with NAFLD show a significant, progressive reduction of LAL activity from simple steatosis to non-alcoholic steatohepatitis and cryptogenic cirrhosis. Among cirrhosis of different etiologies, those with cryptogenic cirrhosis show the most significant reductions of LAL activity. These findings suggest that the modulation of LAL activity may become a possible new therapeutic target for patients with more advanced forms of NAFLD. Moreover, the measurement of LAL activity may represent a possible new marker of disease severity in this clinical setting.
['Baratta|Francesco|F|', 'Pastori|Daniele|D|', 'Ferro|Domenico|D|', 'Carluccio|Giovanna|G|', 'Tozzi|Giulia|G|', 'Angelico|Francesco|F|', 'Violi|Francesco|F|', 'Del Ben|Maria|M|']
D015415:Biomarkers D002788:Cholesterol Esters D018450:Disease Progression D059788:Dried Blood Spot Testing D056947:Enzyme Replacement Therapy D006801:Humans D050356:Lipid Metabolism D008099:Liver D008103:Liver Cirrhosis D008111:Liver Function Tests D008247:Lysosomes D065626:Non-alcoholic Fatty Liver Disease D012720:Severity of Illness Index D002787:Sterol Esterase D014280:Triglycerides D015223:Wolman Disease
Lysosomal acid lipase Non-alcoholic fatty liver disease Wolman disease Cholesterol ester storage disease Non-alcoholic steatohepatitis Cirrhosis