Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:28 November 2013
Reviewer: Amedeo Lonardo
Reviewer's report:
1.The “two-hit theory”, although aften quoted, is not the only nor the most
updated one. Other pathogenic and histogenic views have been proposed and
may be discussed ( Wanless IR, Semin Liver Dis.2004;24:99-106; Lonardo A, et
al. Clinical physiology of NAFLD: a critical overview of pathogenesis and
treatment Expert Review of Endocrinology and metabolism 2010 ; Tilg H,
Hepatology. 2010;52:1836-46.). In particular, the Authors may be willing to
discusss that simple steatosis and NASH are probably two unrelated disorders (
Lonardo A, et al. Expert Rev Gastroenterol Hepatol. 2011;5:135-9. Yilmaz Y.
Aliment Pharmacol Ther. 2012;36:815-23.)
2.The Authors may be willing to discuss that, at variance with other more recent
and validated indices (Ballestri S, et al Liver Int. 2012;32:1242-52.). the
ultrasonographic Hamaguchi score does not specifically predict NASH.
3.The Authors need to be more prudent: Statistical association between US
evidence compatible with steatosis and markers of increased oxydative stress
does not imply casuality. Moreover, the two quoted studies (Pacana T, Curr Opin
Clin Nutr Metab Care 2012,15:641–648. and Sanyal AJ, New Engl J Med
2010,362:1675–1685.) are not guidelines. Finally, based on comparative
analysis, the statement that guidelines support antioxidant treatment should be
deleted (Nascimbeni F, J Hepatol. 2013;59:859-71.).
4.This submission states that “Liver steatosis was defined according to
Hamaguchi criteria based on the presence of abnormally intense, high level
echoes arising from the hepatic parenchyma, liver-kidney difference in echo
amplitude, echo penetration into deep portion of the liver and clarity of liver blood
vessel structure [32-33].” Accordinlgy, reference 32 needs to be deleted.
5.The statement “.....ultrasound, which is a qualitative method inadequate to
quantify less than 30% liver fat content [36].” conflicts with more recent studies
(Dasarathy S, J Hepatol. 2009;51:1061-7).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:28 November 2013
Reviewer: Amedeo Lonardo
Reviewer's report:
1.The “two-hit theory”, although aften quoted, is not the only nor the most
updated one. Other pathogenic and histogenic views have been proposed and
may be discussed ( Wanless IR, Semin Liver Dis.2004;24:99-106; Lonardo A, et
al. Clinical physiology of NAFLD: a critical overview of pathogenesis and
treatment Expert Review of Endocrinology and metabolism 2010 ; Tilg H,
Hepatology. 2010;52:1836-46.). In particular, the Authors may be willing to
discusss that simple steatosis and NASH are probably two unrelated disorders (
Lonardo A, et al. Expert Rev Gastroenterol Hepatol. 2011;5:135-9. Yilmaz Y.
Aliment Pharmacol Ther. 2012;36:815-23.)
2.The Authors may be willing to discuss that, at variance with other more recent
and validated indices (Ballestri S, et al Liver Int. 2012;32:1242-52.). the
ultrasonographic Hamaguchi score does not specifically predict NASH.
3.The Authors need to be more prudent: Statistical association between US
evidence compatible with steatosis and markers of increased oxydative stress
does not imply casuality. Moreover, the two quoted studies (Pacana T, Curr Opin
Clin Nutr Metab Care 2012,15:641–648. and Sanyal AJ, New Engl J Med
2010,362:1675–1685.) are not guidelines. Finally, based on comparative
analysis, the statement that guidelines support antioxidant treatment should be
deleted (Nascimbeni F, J Hepatol. 2013;59:859-71.).
4.This submission states that “Liver steatosis was defined according to
Hamaguchi criteria based on the presence of abnormally intense, high level
echoes arising from the hepatic parenchyma, liver-kidney difference in echo
amplitude, echo penetration into deep portion of the liver and clarity of liver blood
vessel structure [32-33].” Accordinlgy, reference 32 needs to be deleted.
5.The statement “.....ultrasound, which is a qualitative method inadequate to
quantify less than 30% liver fat content [36].” conflicts with more recent studies
(Dasarathy S, J Hepatol. 2009;51:1061-7).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:NOX2-generated oxidative stress is associated with severity of ultrasound
liver steatosis in patients with non-alcoholic fatty liver disease
Version:3Date:28 November 2013
Reviewer: Amedeo Lonardo
Reviewer's report:
1.The “two-hit theory”, although aften quoted, is not the only nor the most
updated one. Other pathogenic and histogenic views have been proposed and
may be discussed ( Wanless IR, Semin Liver Dis.2004;24:99-106; Lonardo A, et
al. Clinical physiology of NAFLD: a critical overview of pathogenesis and
treatment Expert Review of Endocrinology and metabolism 2010 ; Tilg H,
Hepatology. 2010;52:1836-46.). In particular, the Authors may be willing to
discusss that simple steatosis and NASH are probably two unrelated disorders (
Lonardo A, et al. Expert Rev Gastroenterol Hepatol. 2011;5:135-9. Yilmaz Y.
Aliment Pharmacol Ther. 2012;36:815-23.)
2.The Authors may be willing to discuss that, at variance with other more recent
and validated indices (Ballestri S, et al Liver Int. 2012;32:1242-52.). the
ultrasonographic Hamaguchi score does not specifically predict NASH.
3.The Authors need to be more prudent: Statistical association between US
evidence compatible with steatosis and markers of increased oxydative stress
does not imply casuality. Moreover, the two quoted studies (Pacana T, Curr Opin
Clin Nutr Metab Care 2012,15:641–648. and Sanyal AJ, New Engl J Med
2010,362:1675–1685.) are not guidelines. Finally, based on comparative
analysis, the statement that guidelines support antioxidant treatment should be
deleted (Nascimbeni F, J Hepatol. 2013;59:859-71.).
4.This submission states that “Liver steatosis was defined according to
Hamaguchi criteria based on the presence of abnormally intense, high level
echoes arising from the hepatic parenchyma, liver-kidney difference in echo
amplitude, echo penetration into deep portion of the liver and clarity of liver blood
vessel structure [32-33].” Accordinlgy, reference 32 needs to be deleted.
5.The statement “.....ultrasound, which is a qualitative method inadequate to
quantify less than 30% liver fat content [36].” conflicts with more recent studies
(Dasarathy S, J Hepatol. 2009;51:1061-7).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
'I declare that I have no competing interests'
assistant