Figure 2.

A brief comparison of NAFLD/NASH prevention and therapy between astaxanthin and vitamin E. First, astaxanthin is more effective than vitamin E in improving steatosis by suppressing lipid accumulation. Second, astaxanthin is superior to vitamin E with respect to suppressing the MAPK pathway and NF-κB activation and induces a strong shift of M2 macrophage polarization, which ultimately reverses hepatic steatosis, inflammation, and insulin resistance. Most importantly, as a result of M1/M2 transformation, astaxanthin can reduce hepatic stellate cell (HSC) activation and ameliorate hepatic fibrosis. Black arrow: $\uparrow$: induction, $\downarrow$: inhibition, $\to$: no change; Red arrow: $\downarrow$: inhibition compared with vitamin E, $\uparrow \uparrow /\downarrow \downarrow$: more significant induction/inhibition effect compared with vitamin E.