New fatty liver drug shows promise in Tulane study | Health care/Hospitals

Fatty liver disease affects more than a third of adults in the United States, a silent epidemic closely tied to obesity and diabetes. In Louisiana, where both conditions are more common than the national average, doctors suspect the disease is even more widespread, often going undetected until it becomes life-threatening.

Scientists from Tulane University are part of a multi-university team exploring a potential new treatment that could stop the disease before it turns deadly.

In a study published earlier this year in Nature Aging, the team found that a drug called 753b cleared out harmful aging cells known as senescent cells.

Sometimes called “zombie cells,” they build up in the liver as people age or develop obesity and diabetes. The cells no longer function properly, but they don’t die off. Instead, they linger in the body, increasing inflammation and damaging nearby tissue, which sets the stage for disease. 

Senescent cells are a key feature of chronic liver disease, said Liya Pi, a pathologist at Tulane School of Medicine and an author of the study. The drug can clear senescent cells and reduce the development of liver disease to fibrosis and the most common type of liver cancer, she said.

The disease, now called MASLD (metabolic dysfunction-associated steatotic liver disease), was previously known as nonalcoholic fatty liver disease. It rarely causes symptoms in early stages. 

“It’s a poorly recognized disease,” said Dr. George Therapondos, a hepatologist at Ochsner Health who was not involved in the study. “Most people will not have symptoms until they develop liver failure or liver cancer.”

Louisiana has one of the country’s highest rates of liver cancer, with liver and bile duct cancers occurring more often than in nearly any other state, according to federal cancer data. For both mortality and incidence, Louisiana ranks first among states over the last five years. 

Therapondos said the condition is likely even more prevalent due to the state’s high rates of obesity and diabetes, and encouraged screening for people with risk factors. Patients with obesity or diabetes with normal liver enzyme tests may still have the disease.

“Even if your liver tests are normal, you may actually have some disease if you are at risk,” he said. 

For most patients, lifestyle changes such as weight loss and managing blood sugar can help prevent serious complications. But treatment options for advanced disease are limited. One drug is currently approved. In severe cases, liver transplant may be the only option. Donor organs remain in short supply.

The 753b compound is still in early development. It has only been tested in mice, and researchers say it will be years before it could be ready for human trials. Still, Pi hopes the drug could eventually be used alongside existing therapies to better manage disease progression.