Liver cell swelling
Hepatocyte ballooning↓
Also searched as Hepatocyte ballooning.
You want fewer of them. It is the single feature most tightly tied to whether fat has become disease.
In depth
A hepatocyte that has taken on so much injury it swells and loses its normal shape. Pathologists count these under the microscope - it is one of the three things that make up the NAFLD Activity Score, and it is the feature that separates simple fat from steatohepatitis.
What drives it
Eases ER stress increases it.
Verbatim (S2095177925001352, Atractylenolide II): 'AT-II effectively supresses accumulation of lipids and ER stress in palmitic acid-induced hepatocytes' and 'AT-II reduces ER stress, lipogenesis and inflammation... through stimulation of the hepatic FXR-SERCA2-eIF2alpha axis', confirmed by SERCA2 knockdown and FXR silencing. The COUNTERFACTUALS test the ER-stress step, not the ballooning readout. Ballooning was not scored in that paper. This edge asserts the mechanistic link that ER stress drives the swollen-cell phenotype; NO driver is graded on ballooning.
What it drives
It increases Liver inflammation.
10.3390/ijms17010097 — The discriminating feature, and the one the evidence actually moves. Pivens primary endpoint (s1551714408001146): 'either an improvement in nas by 2 or more in at least two NAS features, or a post-treatment NAS of 3 or less, and improvement in hepatocyte ballooning by 1 OR more, and NO worsening of fibrosis' — ballooning improvement is a required term, not an optional one. And tonic in children: 'The only histologic feature of NASH that improved with both medications was ballooning', while steatosis, lobular inflammation and fibrosis scores did not improve. This is why vitamin E carries NASH and not steatosis on this blend. doi 10.3390/ijms17010097
It increases Developmental signaling.
Ballooned, lipotoxically injured hepatocytes are the principal source of Hedgehog ligand in fatty liver disease. PMID 21547909
Blends that modulate it
Each blend page names this pathway and carries the study behind its claim.
See it on the map
Open the causal map to follow this pathway upstream and downstream, arrow by arrow, each with its study.