Does this mean there is no connection between gamma interferon and reversing cirrhosis? It's hard to tell from this study, because monotherapy ANYTHING rarely works for us.
SVRs have elevated gamma levels. Interferon alfa is a cytokine. A cytokine is a messenger. The cytokine sequence goes like this:
alfa IFN--->Interleukin 12--->gamma IFN. So far, we've tried monotherapy megadosing with each one of these cytokines. IL-12 killed a couple of alcoholics with advanced cirrhosis. Actually, they were hoping that shooting IL-12 would increase gamma production.
Okay, here's the other deal. I know a person with lupus who is having trouble with connective tissue fibrosis. lupus people often experience interferon overload. More alfa means more IL-12 which means more gamma. So here, you've got fibrosis developing in a gamma environment.
Then, there's the other deal. I take a drug called Avandia for diabetes. The drug is purported to reverse liver injury as an offshoot messaging sequence that goes along with controlling insulin resistance. Here's the kicker - Avandia is believed to reverse liver injury, and the drug inhibits IL-12 and gamma.
So in the first case, you've got fibrosis in the presence of gamma. In the other case, you've got reversal in the absence of gamma.
Does this mean that gamma interferon has nothing to do with repairing liver injury? Not necessarily. We don't yet fully understand the pathway. There may be a piece missing.