NAFLD Clinical Trial
Official title:
Hydroxytyrosol and Vitamin E in the Treatment of Children With Biopsy-proven NASH
Non-alcoholic fatty liver disease (NAFLD) has reached epidemic proportions and is rapidly
becoming the one of most common causes of chronic liver disease in children. The pathogenesis
of NAFLD is generally considered the result of a series of liver injuries, commonly referred
as "multi-hit" hypothesis. Several studies suggest that inflammatory pathways and oxidative
stress could be responsible of disease progression to non-alcoholic steatohepatitis (NASH).
Hydroxytyrosol is a simple phenolic compound naturally occurring in olive and olive oil with
antioxidant properties. Some studies have demonstrated that hydroxytyrosol show several
anti-inflammatory and anti-atherogenic activities, such as the inhibition of LDL oxidation
and platelet aggregation.
Alpha tocopherol (Vitamin E) is the most studied anti-oxydant in pediatric NAFLD with
conflicting results. It inhibits proinflammatory cytokine production and attenuates the
release of profibrogenic agents and liver collagen.
The purpose of this interventional study is to evaluate the efficacy and tolerability of
Hydroxytyrosol and Vitamin E in the treatment of children with biopsy-proven NASH.
80 children and adolescents (4-16 years) with biopsy-proven NASH will be enrolled. They will
be randomized to treatment with hydroxytyrosol and vitamin E (n: 40 pts) or an identical
placebo (n: 40 pts) given orally for a period of 16 weeks. Patients will undergo a medical
evaluation at baseline (enrollment) and after 4 months (end of treatment). Anthropometric
measures and laboratory assay, includin liver enzymes, gluco-insulinemic and lipid profiles
will be performed at baseline and at the end of the study. Hepatic ultrasound examination
will be performed at enrollment and at the end of the study.
Serum sample for determination of markers of inflammation and oxidative stress will be
collected at enrollment and at the end of the study.
A stool sample for analysis of gut microbioma will be collected at enrollment and at the end
of the study.
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