Non-alcoholic steatohepatitis (NASH) can potentially progress to liver cirrhosis and hepatocellular carcinoma. The causes of this disease are not well defined, and although several therapies have been tried, the optimal treatment has not been established. Recently, a role for angiotensin II in insulin resistance, oxidative stress and hepatic stellate cell activation has been reported. We treated patients who had NASH and hypertension with losartan, an angiotensin II receptor antagonist for 48 weeks. The losartan treatment improved hepatic necroinflammation and fibrosis in NASH patients. Moreover, a disappearance of iron deposition in hepatocytes, and a decrease in activated hepatic stellate cells were detected after treatment. Our results suggest the therapeutic efficacy of angiotensin II receptor antagonist in patients with NASH.
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