Mechanism of NASH improvement by metabolic surgery: the role of changes in bile acid circulation

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09096
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Tohoku University
• Principal Investigator: Tanaka Naoki 東北大学, 大学病院, 講師 (60547404)
• Co-Investigator(Kenkyū-buntansha): 井本 博文 東北大学, 大学病院, 助教 (20754922)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: NASH / Metabolic surgery / duodeno-jejunal bypass

Outline of Final Research Achievements

After duodenal-jejunal bypass (DJB) is performed, remarkable effects of suppressing weight gain and improving diabetic control are observed. Although the effect is canceled by resection of the bilio-pancreatic limb (BPL). In other words, the existence of BPL is important for the effect of metabolic surgery. In this study, we examined the effects of surgery on diet-induced NASH model rats. In the DJB group, a histological improvement in NASH was observed, but the effect was canceled in the BPL resection group. Similar to the diabetic improvement effect, it was confirmed that DJB's NASH improvement effect was canceled by BPL resection.

Free Research Field

消化器外科学

Academic Significance and Societal Importance of the Research Achievements

肥満の増加と供にNASHは増加傾向であり、肝硬変や肝細胞癌の原因となり得る疾患である。NASHに対して減量以外の有効な治療法が無いが、近年、減量手術（代謝改善手術）によるNASHの改善が報告されており、手術が有効な治療法として注目されている。本研究は、NASHに対する代謝改善手術の理論的背景やバイパス長に一定の根拠を付すものである。また、今回得られた知見は、病因や改善機序の解明の一助となり、予防や創薬を含めた治療法の確立に貢献できるものと考える。