Inflammation of the liver – also known as NASH (nonalcoholic steatohepatitis) – is an increasingly common condition in both adults and children. It is usually a reaction to obesity and the associated metabolic syndrome (a condition which relates to the consumption and storage of energy within the body). The number of patients is increasing rapidly. The vast majority of obese people (in some countries up to 90%) are also suffering from fatty liver. In this group, some 20 to 30% simultaneously suffer from inflammation of the liver.

No treatment currently available
Unfortunately, no effective treatment is currently available for hepatitis. The standard treatment is to give lifestyle-related advice: get more exercise, eat less and eat more healthily. Houben's doctoral research has produced two new potential treatment methods. The first research focus area demonstrates that the administration of a vaccine has a beneficial effect on the hepatitis. This vaccine combats the uptake of a specific type of cholesterol in the liver. The reduced uptake of this type of cholesterol in the liver drastically reduces the hepatitis. In the second method, specific proteins in the blood are blocked by the administration of a chemical substance. This appears to have a positive effect on the fat metabolism, which also makes it possible to drastically reduce the inflammation of the liver. The new treatment methods have been tested in animal models and are currently being subjected to new analyses before being tested on people. As a result, it will probably take several years before these methods actually become available to patients.

Blood test
The research also produced a new method of diagnosing hepatitis, namely by means of a simple blood test. This blood test measures specific proteins in the blood which are essential for the breakdown of fats. This will make it possible to diagnose hepatitis. Hepatitis can currently only be diagnosed by taking a biopsy, a method which is much more stressful for the patient. In the future, the new blood test could replace the liver biopsy as a diagnostic tool. Researchers at Maastricht UMC+ are currently working hard to develop this.

About the researchers
Dr Tom Houben recently obtained his doctorate from Maastricht University with his thesis entitled Lysosomes ‘in control’: where lipids meet inflammation in metabolic syndrome. The findings of Professor Shiri-Sverdlov's research group have led to the following scientific publications, among others:
https://www.ncbi.nlm.nih.gov/pubmed/?term=blood-derived+macrophages+prone+to+accumulate
https://www.ncbi.nlm.nih.gov/pubmed/?term=Plasma+cathepsin+D+levels%3A+a+novel+tool+to
https://www.ncbi.nlm.nih.gov/pubmed/28615690