AUTHOR=Schneck Anne-Sophie , Anty Rodolphe , Patouraux Stéphanie , Bonnafous Stéphanie , Rousseau Déborah , Lebeaupin Cynthia , Bailly-Maitre Beatrice , Sans Arnaud , Tran Albert , Gugenheim Jean , Iannelli Antonio , Gual Philippe 

TITLE=Roux-En Y Gastric Bypass Results in Long-Term Remission of Hepatocyte Apoptosis and Hepatic Histological Features of Non-alcoholic Steatohepatitis

JOURNAL=Frontiers in Physiology

VOLUME=7

YEAR=2016

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2016.00344

DOI=10.3389/fphys.2016.00344

ISSN=1664-042X

ABSTRACT=<p>The long-term effects of bariatric surgery on non-alcoholic steatohepatitis (NASH), focusing on liver injury and hepatocyte apoptosis, are not well-established. We here performed a longitudinal study with paired liver biopsies of nine morbidly obese women (median BMI: 42 [38.7; 45.1] kg/m<sup>2</sup>) with NASH with a median follow-up of 55 [44; 75] months after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. LRYGB surgery was associated with significant weight loss (median BMI loss −13.7 [−16.4; −9.5] kg/m<sup>2</sup>), improved hepatic steatosis in all patients (55.5% with total resolution), and resolution of hepatic inflammation and hepatocyte ballooning in 100 and 88.8% of cases, respectively. Alanine aminotransferase levels dropped to normal values while hepatic activated cleaved caspase-3 levels strongly decreased after a median follow-up of 55 months. Hepatocyte apoptosis, as evaluated by serum caspase-generated keratin-18 fragment, improved within the first year following LRYGB and these improvements persisted for at least 55 months. LRYGB in morbidly obese patients with NASH is thus associated with a long-lasting beneficial impact on hepatic steatohepatitis and hepatocyte death.</p>