الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Non-alcoholic fatty liver disease (NAFLD) is a challenging global health problem. It has a complex pathogenesis with lacking of satisfying drug therapy. It may progress into non-alcoholic steatohepatitis (NASH), liver cirrhosis, and hepatocellular carcinoma. The pathogenesis of NAFLD is not fully elucidated. Several evidences suggested multiple mechanisms participating in NAFLD including insulin resistance, nutritional factors, oxidative stress, inflammation, hormones of adipose tissues and genetic factors (Buzzetti et al., 2016).
This work was devoted to investigate the possible effects of multiple drugs on a rat model of NAFLD. The study included three sets of experiments. The first set evaluated the effect of allopurinol, metformin, vitamin E and their combination on fructose fed rats. To achieve this aim, drugs were administered from the start and continued for 4 weeks. The second experiment evaluated the effect of eplerenone,pioglitazone,vitamin D and their combination on HFD fed rats. In this set, the drugs were given for 4 weeks with HFD. The third set evaluated the effect of ketotifen and/or cilostazol on cholesterol induced NAFLD for 4 weeks.
Data of the present study showed that NAFLD caused significant impairment in the physical, metabolic, biochemical, oxidative stress and inflammatory parameters as compared with normal control rats. Hisopathologically, the liver showed hydrobic changes,ballooning,micovesicular steatosis and inflamatory foci.
The effect of above mentioned drugs on physical parameters (body weight and liver weight/body weight ratio), metabolic parameters (serum and hepatic TG, blood glucose), biochemical parameters (serum ALT and AST), oxidative stress parameters (GSH, SOD and lipid peroxides) and inflammatory parameters (uric acid and TNFα) were evaluated. Additiomnally, histopathological studies were done.
The results of this study reported that allopurinol (30 mg/kg/day) in combination with metformin150 mg/kg/day + vitamin E 100 mg/kg/day for 4 weeks, eplerenone (25 mg/kg/day) combined with pioglitazone 5mg/kg/day+ vitamin D 0.25µg/kg/day for 4 weeks, ketotifen (1mg/kg/day) combined with cilostazol (20 mg/kg/day) for 4 weeks prevented the development of NAFLD in different rat models more significant than single drug treatment.
In conclusion, the results of this study reported that drug combinations in treatment of NAFLD are superior to monotherepy.