exciting to work on a disease that is so common, and presents us with so many unanswered ques- tions. I’m a pharmacist by train- ing, so I think that treating an early stage of the disease is better.


References:


1: Sanyal AJ, Chalasani N, Kowdley KV, et al. Piogli- tazone, vitamin E, or placebo for nonalcoholic steato- hepatitis. N Engl J Med 2010; 362 (18): 1675-1685.


2: Lavine JE, Schwimmer JB, Van Natta ML, et al. Ef- fects of vitamin E or metformin for treatment of nonal- coholic fatty liver disease in children and adolescents. JAMA 2010; 305 (16): 1659-1668.


3. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG,


Gluud C. (2008) Antioxidant supplements for pre- vention of mortality in healthy participants and pa- tients with various diseases. Cochrane Database Syst Rev 2;Art. No.: CD007176. DOI:10.1002/14651858. CD007176.


4. Magosso E, Ansari MA, Gopalan Y, et al. (2010). Tocotrienols and Nonalcoholic Fatty Liver: a Clinical Experience. 61st Liver Meeting, American Association for the Study of Liver Diseases (AASLD). 28 October-2 November 2010, Hynes Convention Center, Boston, MA (USA). In Hepatology 2010;52(4 Supp):642.


Tocotrienols, Probiotics and Glycophospholipids A Perfect Prescription for the Liver? By Michael Ash, BSc, DO, ND, F.DipION


One of my primary areas of re- search and expertise is the gut microbiota and its diverse im- pact on our health. Your liver receives nearly 70% of its blood supply from the intestine, and represents a first line of defence against gut-derived antigens. Intestinal bacteria—and the antigens they produce—play a key role in the maintenance of gut-liver axis health. Modu- lation of the gut microbiota to achieve and maintain symbi- osis represents a new way to treat or prevent non-alcoholic fatty


liver disease (NAFLD).


Along with the concomitant use of tocotrienols and glycophos- pholipids, we may be starting to see the emergence of a tru- ly profound intervention for a complex metabolic disease, us- ing safe, natural compounds.


Here is how I see the three ap- proaches merging. First, mem- brane consistent glycophos- pholipids are used to repair the bi-layer of the mitochondrial


membrane. In the August 2012 issue of Focus, Garth Nichol- son, PhD, and I wrote about the emerging role of the mitochon- dria—and damage to the mito- chondrial lipid membrane—in integrative medicine. We ex- plored how glycophospholipid replacement could reduce ad- verse spillage of reactive oxygen species (ROS), the energy-carry- ing enzyme ATP and oxidized DNA. The latter two are known as Damage Associated Molecular Patterns (DAMPS).


We also wrote about gastroin- testinal bacterial dysbiosis, and the consequential increase in pathogen-associated


prokaryotes. This historical genetic lineage means bacterial antigens and mitochondrial DNA are recognized by the same immune receptors on and in cells. The intracellular receptors, when activated, release two potent cytokines - IL-1β & IL-18. Research shows these cytokines are intimately linked to liver diseases including NAFLD and are instrumental in its progression to non-alcoholic steatohepatitis (NASH) .


microbi-


al patterns (PAMPS) . Togeth- er, DAMPS and PAMPS drive inflammation and heighten receptor sensitivity in both tis- sues - with adverse outcomes in human health and physiology.


Mitochondria and gastrointestinal bacteria share a common ancestry—bacterial cells called


A “two hit” mitochondrial mechanism may drive NA- FLD/NASH pathogenesis. The first hit, hepatic steatosis, is closely


associated with lipo- toxicity-induced mitochondri- al abnormalities that sensitize the liver to additional pro-in- flammatory insults. The sec- ond hits include enhanced mi- tochondrial lipid peroxidation and increased


generation of


reactive oxygen species (ROS) and increased release of oxi- dised mitochondrial DNA.


Focus April 2013 17


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