Aim. Nonalcoholic steatohepatitis (NASH) is the consequence of insulin resistance, fatty acid accumulation, oxidative stress, and
lipotoxicity.We hypothesize that an increase in the inflammatory adipokine NOV decreases antioxidant Heme Oxygenase 1 (HO-
1) levels in adipose and hepatic tissue, resulting in the development of NASH in obese mice. Methods. Mice were fed a high
fat diet (HFD) and obese animals were administered an HO-1 inducer with or without an inhibitor of HO activity to examine
levels of adipose-derived NOV and possible links between increased synthesis of inflammatory adipokines and hepatic pathology.
Results. NASH mice displayed decreased HO-1 levels and HO activity, increased levels of hepatic heme, NOV, MMP2, hepcidin,
and increased NAS scores and hepatic fibrosis. IncreasedHO-1 levels are associated with a decrease in NOV, improved hepatic NAS
score, ameliorated fibrosis, and increases in mitochondrial integrity and insulin receptor phosphorylation. Adipose tissue function
is disrupted in obesity as evidenced by an increase in proinflammatory molecules such as NOV and a decrease in adiponectin.
Importantly, increased HO-1 levels are associated with a decrease of NOV, increased adiponectin levels, and increased levels of
thermogenic and mitochondrial signaling associated genes in adipose tissue. Conclusions.These results suggest that the metabolic
abnormalities in NASH are driven by decreased levels of hepatic HO-1 that is associated with an increase in the adipose-derived
proinflammatory adipokine NOV in our obese mouse model of NASH. Concurrently, induction of HO-1 provides protection
against insulin resistance as seen by increased insulin receptor phosphorylation. Pharmacological increases in HO-1 associated
with decreases in NOV may offer a potential therapeutic approach in preventing fibrosis, mitochondrial dysfunction, and the
development of NASH