Association between Chronic Liver Disease and Atherosclerosis: An Inflammation as Common Pathway

Atherosclerosis status as an inflammatory disease has been suggested and anti-inflammatory therapy with canakinumab for atherosclerotic disease has been recently reported. The author previously described the relationship between APRI (aspartate aminotransferase to platelet ratio index) and endothelial function assessed by Flow-Mediated Vasodilation (FMD), thereby suggesting that APRI may reflect systemic atherosclerosis condition in elderly patients without hepatic-related causes. Some reports of the relationship between NAFLD/NASH and atherosclerosis status and between chronic Hepatitis C Virus (HCV) infection and atherosclerotic state have been described. As both chronic liver disease and atherosclerosis involve severe inflammatory processes, at least common pathway may be present for the development and treatment of these inflammatory diseases. The current knowledge of the relationship between chronic liver diseases (NAFLD/NASH and HCV infection) and atherosclerosis and a novel therapeutic strategy is reviewed. Based on the several evidences, the author suggests that an association between chronic liver disease and systemic atherosclerosis may be present due to the presence of the inflammation as a common pathway. It is plausible that direct acting antivirus therapy is a potential strategy for not only liver disease but also endothelial dysfunction and atherosclerosis in patient with HCV infection. It has been suggested that momelotinib as a novel treatment may play a potential therapeutic benefit to a high-risk patients with NAFLD/NASH.