Effects of PPARα, PPARγ, and dual PPARα/γ agonists on liver tissue and biochemical markers in NAFLD-induced Wistar rats

Elham Khoshbakht, Negar Dinarvand, Hamid Yaghooti, Behrouz Taheri, Narges Mohammadtaghvaei

Abstract


Background and purpose: Non-alcoholic fatty liver disease (NAFLD) is the most common liver-related metabolic disorder worldwide, affecting approximately 25% of the global population. Peroxisome proliferator-activated receptor (PPAR) agonists play an important role in NAFLD management through modulation of lipid metabolism and insulin sensitivity. This study compared the effects of fenofibrate (PPARα agonist), pioglitazone (PPARγ agonist), and saroglitazar (dual PPARα/γ agonist) in a high-fat diet (HFD)-induced NAFLD rat model.

Experimental approach: NAFLD was induced in Wistar rats by feeding a high-fat diet. Animals were assigned to control, HFD, and HFD-treated groups receiving saroglitazar (3 mg/kg), pioglitazone (30 mg/kg), or fenofibrate (100 mg/kg) for six weeks. Anthropometric parameters, serum liver enzymes, lipid profile, fasting blood glucose, and HOMA-IR were assessed. Histopathological changes were evaluated using H&E and Masson’s trichrome staining. Hepatic expression of FGF21, CPT-1, PPARα, SREBP-1c, and ACC was analyzed by quantitative RT-PCR.

Findings/Results: All three PPAR agonists significantly improved hepatic steatosis, inflammation, and fibrosis compared with the HFD group, despite variability in biochemical and metabolic parameters. Among the treatments, saroglitazar demonstrated the most pronounced histological improvement, although systemic metabolic improvements were comparable among all three agents.

Conclusion and implications: Fenofibrate, pioglitazone, and saroglitazar exert beneficial effects on NAFLD progression through partially distinct mechanisms. Dual PPARα/γ activation appears to preferentially enhance hepatic histological outcomes, supporting the therapeutic relevance of saroglitazar in NAFLD.

 


Keywords


Fenofibrate; NAFLD; NASH; Pioglitazone; Saroglitazar.

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References


Qiu YY, Zhang J, Zeng FY, Zhu YZ. Roles of the peroxisome proliferator-activated receptors (PPARs) in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Pharmacol Res. 2023;192:106786,1-16. DOI: 10.1016/j.phrs.2023.106786.

El-Wakf A, El-Sawi M, Obaid T, Elmougy R. Dill extract attenuates liver fibrosis and steatohepatitis in obese rats via modulating TGF-β1 signaling and collagen accumulation. Res Pharm Sci. 2025;20(6):836-852. DOI: 10.4103/RPS.RPS_187_24.

Skat‐Rørdam J, Højland Ipsen D, Lykkesfeldt J, Tveden‐Nyborg P. A role of peroxisome proliferator‐activated receptor γ in non‐alcoholic fatty liver disease. Basic Clin Pharmacol Toxicol. 2019;124(5):528-537. DOI: 10.1111/bcpt.13190.

Yarahmadi S, Sotoudeheian M, Farahmandian N, Mohammadi Y, Koushki M, Babaeenezhad E, et al. Effect of resveratrol on key signaling pathways, including SIRT1/AMPK/Smad3/TGF-β and miRNA-141 related to NAFLD in an animal model. Pharmacol Res. 2025;20(3):434-444. DOI: 10.4103/RPS.RPS_220_24.

Higashi T, Friedman SL, Hoshida Y. Hepatic stellate cells as key target in liver fibrosis. Adv Drug Deliv Rev. 2017;121:27-42. DOI: 10.1016/j.addr.2017.05.007.

Peng Y, Li L, Zhang X, Xie M, Yang C, Tu S, et al. Fluorofenidone affects hepatic stellate cell activation in hepatic fibrosis by targeting the TGF-β1/Smad and MAPK signaling pathways. Exp Ther Med. 2019;18(1):41-48. DOI: 10.3892/etm.2019.7548.

Pan J, Zhou W, Xu R, Xing L, Ji G, Dang Y. Natural PPARs agonists for the treatment of nonalcoholic fatty liver disease. Biomed Pharmacother. 2022;151:113127,1-7.DOI: 10.1016/j.biopha.2022.113127.

Lange NF, Graf V, Caussy C, Dufour JF. PPAR-targeted therapies in the treatment of non-alcoholic fatty liver disease in diabetic patients. Int J Mol Sci. 2022;23(8):4305,1-35. DOI: 10.3390/ijms23084305.

Akbari R, Yaghooti H, Jalali MT, Khorsandi LS, Mohammadtaghvaei N. Capparis spinosa improves non-alcoholic steatohepatitis through down-regulating SREBP-1c and a PPAR α-independent pathway in high-fat diet-fed rats. BMC Res Notes. 2022;15(1):315,1-8. DOI: 10.1186/s13104-022-06205-x.

Hong F, Pan S, Guo Y, Xu P, Zhai Y. PPARs as nuclear receptors for nutrient and energy metabolism. Mol. 2019;24(14):2545,1-20. DOI: 10.3390/molecules24142545.

Siddiqui MS, Parmar D, Sheikh F, Sarin SK, Cisneros L, Gawrieh S, et al. Saroglitazar, a dual PPAR α/γ agonist, improves atherogenic dyslipidemia in patients with non-cirrhotic nonalcoholic fatty liver disease: a pooled analysis. Clin Gastroenterol Hepatol. 2023;21(10):2597-2605. DOI: 10.1016/j.cgh.2023.01.018.

Akbari R, Behdarvand T, Afarin R, Yaghooti H, Jalali MT, Mohammadtaghvaei N. Saroglitazar improved hepatic steatosis and fibrosis by modulating inflammatory cytokines and adiponectin in an animal model of non-alcoholic steatohepatitis. BMC Pharmacol Toxicol. 2021;22(1):53,1-9. DOI: 10.1186/s40360-021-00524-8.

Zou Y, Li J, Lu C, Wang J, Ge J, Huang Y, et al. High-fat emulsion-induced rat model of nonalcoholic steatohepatitis. Life Sci. 2006;79(11):1100-1107. DOI: 10.1016/j.lfs.2006.03.021.

Malekinejad H, Zeynali-Moghaddam S, Rezaei-Golmisheh A, Alenabi A, Malekinejad F, Alizadeh A, et al. Lupeol attenuated the NAFLD and PCOS-induced metabolic, oxidative, hormonal, histopathological, and molecular injuries in mice. Res Pharm Sci. 2023;18(5):551-565. DOI: 10.4103/1735-5362.383710.

Jain MR, Giri SR, Bhoi B, Trivedi C, Rath A, Rathod R, et al. Dual PPAR α/γ agonist saroglitazar improves liver histopathology and biochemistry in experimental NASH models. Liver Int. 2018;38(6):1084-1094. DOI: 10.1111/liv.13634.

Avni Y, Shirin H, Aeed H, Shahmurov M, Birkenfeld S, Bruck R. Thioacetamide-induced hepatic damage in a rat nutritional model of steatohepatitis. Hepatol Res. 2004;30(3):141-147. DOI: 10.1016/j.hepres.2004.08.004.

Li N, Li X, Ding Y, Liu X, Diggle K, Kisseleva T, et al. SREBP regulation of lipid metabolism in liver disease, and therapeutic strategies. Biomedicines. 2023;11(12):3280,1-17. DOI: 10.3390/biomedicines11123280.

Jin Y, Shangguan Z, Pang J, Chen Y, Lin S, Liu H. Pin1 exacerbates non-alcoholic fatty liver disease by enhancing its activity through binding to ACC1. Int J Mol Sci. 2024;25(11):5822,1-21. DOI: 10.3390/ijms25115822.

Xiao M, Tang Y, Wang S, Wang J, Wang J, Guo Y, et al. The role of fibroblast growth factor 21 in diabetic cardiovascular complications and related epigenetic mechanisms. Front Endocrinol. 2021;12:598008,1-10. DOI: 10.3389/fendo.2021.598008.

Song S, Attia RR, Connaughton S, Niesen MI, Ness GC, Elam MB, et al. Peroxisome proliferator-activated receptor α (PPARα) and PPAR gamma coactivator (PGC-1α) induce carnitine palmitoyltransferase IA (CPT-1A) via independent gene elements. Mol Cell Endocrinol. 2010;325(1-2):54-63. DOI: 10.1016/j.mce.2010.05.019.

Zhang D, Niu S, Ma Y, Chen H, Wen Y, Li M, et al. Fenofibrate improves insulin resistance and hepatic steatosis and regulates the Let-7/SERCA2b axis in high-fat diet-induced non-alcoholic fatty liver disease mice. Front Pharmacol. 2022;12:770652,1-9. DOI: 10.3389/fphar.2021.770652.

Sayadishahraki M, Mirfendereski S, Kachuei A, Zadeh AR, Mirghaderi A. Effect of pioglitazone on nonalcoholic fatty liver disease in morbid obese patients; a randomized controlled trial. Adv Biomed Res. 2023;12(1):27. DOI: 10.4103/abr.abr_354_21.

Wang Z, Du H, Zhao Y, Ren Y, Ma C, Chen H, et al. Response to pioglitazone in non-alcoholic fatty liver disease patients with vs. without type 2 diabetes: a meta-analysis of randomized controlled trials. Front Endocrinol. 2023;14:1111430,1-11. DOI: 10.3389/fendo.2023.1111430.

Yaghoubi M, Jafari S, Sajedi B, Gohari S, Akbarieh S, Heydari AH, et al. Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol. 2017;29(12):1385-1388. DOI: 10.1097/MEG.0000000000000981.


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