Review for 10.1186/1471-230X-14-39 (2014)

Reviewer's report
Title:The relationship between hepatic resistin overexpression and inflammation
in patients with nonalcoholic steatohepatitis
Version:1Date:1 November 2013
Reviewer: ALEXANDER WREE
Reviewer's report:
Reviewer’s comment:
The manuscript by Shen et al. describes the relationship between hepatic resistin
overexpression and inflammation in patients with non-alcoholic steatohepatitis.
They report an increase in serum resistin levels in patients with biopsy proven
NAFLD when compared to healthy serum samples of healthy blood donor
volunteers. In the analysis of hepatic mRNA resistin levels they found increased
levels in Patients with NASH when compared to patients with simple steatosis.
Likewise, hepatic resistin protein expression was increased patients with NASH.
Major comments:
1. Although the manuscript presents interesting results, multiple grammatical and
typing errors distract the reader so much that it is difficult to judge the scientific
impact of the work. The authors need to pay closer attention to the journals
requirements. Non-native speakers of English may choose to make use of a
copyediting service.
2. The authors classified the histological diagnosis of NASH in accordance with
Brunt et al Am J Gastroenterol 1999. Nowadays, liver samples in patients with
NAFLD are characterized using the NAFLD activity scoring system and fibrosis
staging system as published by Kleiner et al. Hepatology 2005. Authors should
use this most recent system to compare results of their study to the work of
others.
3. The authors state the ‘Fatty liver is a harmless (benign) condition,…’. This
statement needs to be underpinned by a recent reference. Interestingly, the
simple steatosis cohort in this study exhibited increased ALT, ASL, and GGT
serum levels of 68 + 13 U/l, 35 ± 8 U/l, and 80 ± 15 U/l.
4. Resistin is known to be present in macrophages and monocytes in humans.
Both cell types are already known as hallmarks within the development of
NAFLD and NASH. The authors need to verify that the resistin positive cell
population differs from the overall macrophage population.
Minor comments and errata
1. The figure labels need to be more informative and precise. The correlation of
serum resistin levels with the grade of steatosis (Fig 2A) should be integrated in
Fig 1.
2. Fig 2 B/C: Liver samples of patients with simple steatosis need to be scored
for Lobular Inflammation and Stage of Fibrosis even if those samples might show
a score of 0, and those scores need to be included in figure 2.
3. References [11] and [12] are only available in Chinese. This references should
be backed by studies that are accessible by the broad readership of BMC
Gastroenterology.
With the suggested revisions regarding language, methodological aspects,
experiments and discussion the manuscript by Shen et al. may be re-submitted
after extensive review to BMC Gastroenterology. Without additional clarification
and changes to the manuscript I would advise against publication in the
presented form.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests