The involvement of hypoxia-inducible factor-1 alpha (HIF-1 alpha), transforming growth factor-beta 1 (TGF-beta 1), Smad and beta-catenin signaling pathway in non-alcoholic fatty liver disease (NAFLD) is not fully elucidated. Pioglitazone improves NAFLD, whereas the underlying molecular mechanisms are not extensively clarified. In addition, cranberry and cinnamon have received increasing attention as potential therapeutic agents in metabolic disorders. Hence, this study aimed to test the hypothesis that the downregulation of HIF-1 alpha/TGF-beta 1/Smad/beta-catenin signaling might underlie the pioglitazone effect in HFD-induced liver steatosis in rats. In addition, the study aimed to determine whether the concurrent use of cranberry and/or cinnamaldehyde would boost biochemical and molecular gains of pioglitazone while limiting its significant side effect; weight gain. Rats were kept on a high-fat diet for 14 weeks, and HFD rats were orally treated with pioglitazone, cranberry, or their combinations for 8 weeks. Pioglitazone, cranberry, and to a lesser extent cinnamaldehyde significantly ameliorated the pathological lesions, improved the hepatic histological structure of cinnamaldehyde, and successfully rectified liver index, AST, ALT, lipid profile, hepatic triglycerides, and HOMA-IR. They also inhibited HIF-1 alpha, beta-catenin, TGF-beta 1 and subsequently inhibited phosphorylated/total Smad2/3 and their ratios. In conclusion, the beneficial effects of this combination in HFD-induced hepatic steatosis might be attributed to the modulation of hypoxia/HIF-1 alpha, TGF-beta 1/Smads, and Wnt/beta-catenin pathways in the liver. Thus, cranberry and cinnamon might be potential add-on agents to other pharmacotherapies in liver steatosis.

While the prevalence of metabolic syndrome (MetS) is steadily increasing worldwide, no optimal pharmacotherapy is readily available to address its multifaceted risk factors and halt its complications. This growing challenge mandates the development of other future curative directions. The purpose of the present study is to investigate the efficacy of cranberry proanthocyanidins (PACs) in improving MetS pathological conditions and liver complications; C57BL/6J mice were fed either a standard chow or a high fat/high sucrose (HFHS) diet with and without PACs (200 mg/kg), delivered by daily gavage for 12 weeks. Our results show that PACs lowered HFHS-induced obesity, insulin resistance, and hyperlipidemia. In conjunction, PACs lessened circulatory markers of oxidative stress (OxS) and inflammation. Similarly, the anti-oxidative and anti-inflammatory capacities of PACs were noted in the liver in association with improved hepatic steatosis. Inhibition of lipogenesis and stimulation of beta-oxidation could account for PACs-mediated decline of fatty liver as evidenced not only by the expression of rate-limiting enzymes but also by the status of AMPKα (the key sensor of cellular energy) and the powerful transcription factors (PPARα, PGC1α, SREBP1c, ChREBP). Likewise, treatment with PACs resulted in the downregulation of critical enzymes of liver gluconeogenesis, a process contributing to increased rates of glucose production in type 2 diabetes. Our findings demonstrate that PACs prevented obesity and improved insulin resistance likely via suppression of OxS and inflammation while diminishing hyperlipidemia and fatty liver disease, as clear evidence for their strength of fighting the cluster of MetS abnormalities

Background and Objective: Cholestasis is a liver disease that occurs when bile flow is restricted or blocked. Estrogen-induced cholestasis is marked by a reduction in bile flow and the accumulation of bile acids in the liver as well as liver damage. The aim was to evaluate the hepatoprotective effect on EE-induced cholestasis in rats of Cranberry Water Extract (CWE). Materials and Methods: Adult albino rats weighing approximately 150+or-10 g were divided into six groups of six animals each. As control groups, three groups (I, II and IV) and three experimental groups were used (III, V, VI). Results: Oral administration for 15 days of CWE (150 mg kg- 1 b.wt.) in EE-treated rats (100 g kg- 1 5 days b.wt.) improved serum cholesterol, bile acid and TBIL as well as hepatic SOD and GPx significantly. Also, CWE inhibited ALP, ALT, P-GT activity as well as levels of TNF-a, NO, MMP-2 and MMP-9 and MDA in comparison with the EE treatment rats. On the other hand, the liver TLR4, NF-B and p38MAPK gene expression was down regulated group of rats administrated with cranberry extract when compared with the EE-treated rats. CWE's prophylactic action II is more pronounced than prophylactic one. The hepatoprotective effects of cranberry in restoring normal liver functional ability were also supported by histopathological examination of liver tissues. Conclusion: The results show clearly that cranberry extract has a strong prophylactic effect in EE-induced cholestasis by normalizing the levels of TLR4, NF-B and p38MAPK gene expression.