Protein and RNA levels of angiogenic and inflammatory factors were significantly up-regulated in the liver of C56BL/6 and db/db mice ATR inhibitor with NASH at different timepoints. To examine the effect of angiogenic factors on the disease progression of NASH, a prevention and treatment study was set up, blocking the placental growth factor (PlGF) or vascular endothelial growth factor receptor 2 (VEGFR2). Our study showed that treatment prevents the progression of NASH by attenuating steatosis and inflammation,

both in a preventive and therapeutic setting, thereby confirming the hypothesis that angiogenic factors play an early role in the disease progression from steatosis to NASH. Anti-PlGF (αPlGF) did not significantly improve liver histology. Vascular corrosion casting showed a more disrupted liver vasculature in mice with NASH compared to controls. Treatment with αVEGFR2

showed an improvement of the liver vasculature. Moreover, fat-laden primary hepatocytes treated with αVEGFR2 stored significantly less lipids. Conclusion: Our results demonstrate that there is an increased expression of angiogenic factors in the liver in different mouse models for NASH. We found that VEGFR2 blockage attenuates steatosis and inflammation in a diet-induced mouse model for NASH in Cell Cycle inhibitor a preventive and therapeutic setting. Our findings warrant further investigation of the role of angiogenesis in the pathophysiology in NASH. (HEPATOLOGY 2013) Nonalcoholic steatohepatitis (NASH) is medchemexpress the most severe form of nonalcoholic fatty liver disease (NAFLD) and a serious consequence of the current obesity epidemic.1 NASH is present in more than one-third of the NAFLD cases and is recognized as a potentially progressive disease that may cause fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).2 At present, a multimodal treatment plan that targets obesity, insulin resistance, hyperlipidemia, and hypertension appears to be the only effective means of improving NASH.3 The two-hit

theory, proposed in 1998 by James and Day,4 is the first theory that gave a plausible explanation for the pathogenesis of NASH. This hypothesis suggests that the first hit is caused by steatosis and the second hit is a synergy of oxidative stress and inflammation. Recently, Tilg and Moschen5 described the inflammatory process as a multiple parallel theory. However, the pathogenesis of NASH is still not fully understood. The recognized mechanisms as stated above do not fully explain the range of symptoms and physiological processes found in the disease progression. Nonetheless, the pathophysiology of NASH should be approached as a multifactorial process. In several stages of NASH, a link might be made between disease progression and hepatic microvasculature changes such as angiogenesis.