Duodenal mucosal ablation with irreversible electroporation in non-alcoholic fatty liver disease: Roadmap of the future treatment

Abstract

One of the main causes of liver fibrosis and cancer, non-alcoholic fatty liver disease (NAFLD) is becoming more common every year. The novel work by Yu et al, which evaluates the viability and efficacy of duodenal mucosal ablation (DMA) with irreversible electroporation (IRE) in NAFLD rat models, is examined in this article. When DMA was used with IRE to small rodents, the study found that the duodenum healed successfully two weeks later and had thicker myenterons, narrower and shallower crypts, and slimmer villi than in the sham-control group. When DMA with IRE were used, liver lipid deposition and serum lipid index values decreased; these improvements occurred regardless of food consumption or weight loss. Furthermore, the DMA group's enteroendocrine parameters varied among the various duodenal areas, including claudin and zonula ocludens-1 Levels in the duodenal mucosa. As a result, DMA with IRE in rodents demonstrated no duodenal bleeding or perforation following ablation, providing a promising path for more advanced NAFLD treatment approaches. In order to improve approach outcomes, this paper addresses the implications of extending the study length and animal size, analyzing inflammatory marker studies, and measuring intestinal lipid indexes and endocrine parameters on a weekly basis.

Keywords: Non-alcoholic fatty liver disease; Duodenal mucosal ablation; Irreversible electroporation; Lipid deposition; Endocrine function; Inflammatory markers

Core Tip: The novel work by Yu et al on the feasibility and efficacy of duodenal mucosal ablation (DMA) with irreversible electroporation (IRE) in non-alcoholic fatty liver disease (NAFLD) rodents is thoroughly examined in this article. The duodenum repaired effectively two weeks after DMA with IRE, according to the study in a sophisticated manner. In NAFLD small rats, the detection of liver lipid deposition, serum lipid parameters, and enteroendocrine parameters such claudin and zonula ocludens-1 levels offer new opportunities for side-effects assessment and advanced therapy approaches.