Role of CD44 in Non-Alcoholic Steatohepatitis (NASH) Progressivity

Abstract

Non alcoholic Steatohepatitis (NASH) is part of a group of conditions called Non-Alcoholic Fatty Liver Diseases
(NAFLD) where it is a chronic disease, which defined after elimination other causes of fatty liver, such as excessive
alcohol consumption and other causes of chronic liver diseases. NASH is fatty liver disease which characterized by
ballooning of hepatocyte and lobular inflammation with or without fibrosis. Histopathology diagnose on NASH can be
defined by performing liver biopsy. The purpose of liver biopsy is to define level and degree of the disease. Cluster of
Differentiation (CD) 44 is a transmembrane glycoprotein receptor which located on the surface of macrophage cells,
lymphocytes and endothelial cells. In studies which conducted on mice and humans, showed that CD44 plays
important role in the progression of NASH. CD44 regulates inflammation of adipose tissue and liver. CD44 is
presumed as a marker which increase macrophage infiltration and other inflammatory cells on liver. This process
leads to ultimate increment on insulin resistance and fatty liver. Deficiency was discovered on mice which injected
with methionine and choline deficiency diet (MCDD). CD44 is associated with preventive method to prevent liver
complication by reducing macrophage or monocyte and as well as neutrophil accumulation in liver which was
evaluated through reducing numbers of inflammatory focus, expression of inflammatory cytokines: tumor necrosis
factor α (TNFα), interleukin (IL) -1B and nitric oxide synthesis (iNOS), and pro-inflammatory types of macrophage. In
obese patients, number of CD44 is predicted to be increasing.