Beyond insulin resistance: Innate immunity in nonalcoholic steatohepatitis

Abstract
Obesity is an inflammatory disorder characterized by heightened activity of the innate immune system. Innate immune activation is central to the development of obesity‐related insulin resistance; it also plays an important role in obesity‐related tissue damage, such as that seen in atherosclerosis. Recent research has implicated the innate immune system in the pathophysiology of obesity‐related liver disease. This review summarizes how innate immune processes, occurring both within and outside the liver, cause not only insulin resistance but also end‐organ damage in the form of nonalcoholic fatty liver disease. (HEPATOLOGY 2008;48:670–678.)