Anti-Fibrotic, Anti-Inflammatory, Anti-HCC Experimentals

Ursodeoxycholic Acid May Reduce Liver Inflammation in Patients with Chronic Hepatitis C

By Liz Highleyman

Combination therapy with pegylated interferon (Pegasys or PegIntron) plus ribavirin has improved treatment for chronic hepatitis C, but many patients -- especially those with genotype 1 HCV -- fail to achieve sustained virological response. Such individuals could benefit from therapies that reduce liver inflammation and fibrosis, even if they do not produce virological suppression.

As reported in the June 25, 2007 advance online edition of Gut, researchers from the University of Tokyo assessed the effect of oral ursodeoxycholic acid (UDCA) on serum biomarkers in non-responders to prior interferon-based therapy. Chronic hepatitis C patients with elevated alanine aminotransferase (ALT) levels were randomly assigned to receive UDCA at doses of 150 mg/day (n = 199), 600 mg/day (n = 200), or 900 mg/day (n = 197) for 24 weeks. Changes in ALT, aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) were measured.

Results

    • ALT, AST, and GGT levels decreased at week 4, then remained constant for the remainder of the drug administration period.

    • The median changes in the UDCA 150, 600, and 900 mg/day dose groups, respectively, were:

    - ALT: -15.3%, -29.2%, and -36.2%;
    - AST: -13.6%, -25.0%, and -29.8%%;
    - GGT: -22.4%, -41.0%, and -50.0%.

    • All 3 biomarkers decreased significantly less in the UDCA 150 mg/day arm compared with the 2 higher dose groups.

    • While changes in ALT and AST did not differ between the 600 and 900 mg/day dose groups, GGT was significantly lower in the 900 mg/day group.

    • In a subgroup analysis, ALT decreased significantly in the 900 mg/day group when baseline GGT exceeded 80 IU/L.

    • Serum HCV RNA levels did not change in any group.

    • Adverse side effects were reported by 19.1% of the patients, with no differences between the 3 dose groups.

Conclusion

In conclusion, the authors wrote, "A 600 mg/day UDCA dose was optimal to decrease ALT and AST levels in chronic hepatitis C patients. The 900 mg/day dose decreased GGT levels further, and may be preferable in patients with prevailing biliary injuries."

http://www.hivandhepatitis.com/hep_c/news/2007/070607_a.html


Cont...

[jmjm530]

Experimental Botanical Therapies for Hepatitis C  

By Liz Highleyman

Given that current standard therapy for chronic hepatitis C (pegylated interferon alpha plus ribavirin) does not cure about half of all patients, and that there are no proven effective treatments for liver fibrosis, researchers have explored a wide range of complementary and alternative (CAM) therapies for management of the disease.

Two studies presented at the recent 58th Annual Meeting of the American Association for the Study of Liver Diseases in Boston (November 2-6, 2007) looked at botanical therapies for patients with hepatitis C.

Glycyrrhizin

Glycyrrhizin, derived from licorice root (Glychyrrhiza glabra), has long been used in traditional Asian medicine to treat liver conditions. In Japan, it has been used as a treatment for hepatitis C for more than 20 years. However, there is less data on the use of glycyrrhizin in non-Asian patients.

M.P. Manns and colleagues conducted a study to assess the safety and efficacy of glycyrrhizin in chronic hepatitis C patients in Western and Eastern Europe who did not achieve sustained response to standard combination anti-HCV therapy. Efficacy was defined in terms of biochemical response (ALT reduction) and histological response (improvement of necroinflammation), not virological response (HCV viral load reduction).

All 374 participants were non-responders or relapsers to prior treatment with conventional or pegylated interferon plus ribavirin. At baseline, they had detectable HCV RNA and abnormal ALT (mean 77 IU/L); 73% had HCV genotype 1. The mean necroinflammation score was 7.6 and the mean fibrosis score was 3.1. Liver biopsy results were available at study entry or performed within 6 months.

The trial consisted of 2 phases. Phase 1 was a randomized, double-blind, placebo-controlled comparison of intravenous injections of 200 mg glycyrrhizic acid 5 or 3 times per week, or placebo 5 times per week, for 12 weeks. The following Phase 2 was a randomized, open-label comparison of 200 mg glycyrrhizin administered 5 or 3 times per week for an additional 40 weeks, with no placebo arm.

Results

• 30% of patients in the 5 times weekly glycyrrhizin arm and 32% in the 3 times weekly glycyrrhizin arm had ≥50% ALT reduction after 12 weeks, significantly higher than the 6% in the placebo arm.

• Based on evaluable biopsies taken before and at the end of treatment (n=249), 45% of patients experienced histological improvement (defined as at least 1 point difference in necroinflammation score) and 17% had stable histology (that is, 62% had no histological worsening).

• About 4% of patients discontinued therapy due to treatment-related adverse events.

• Favorable results were also seen in secondary endpoints, including quality of life.

The investigators concluded that, “Glycyrrhizin appears to be effective and well tolerated in the treatment of chronic hepatitis C [patients] not responding to interferon alpha or pegylated interferon plus ribavirin therapy.”

http://www.hivandhepatitis.com/2007icr/aasld/docs/120407_b.html

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[jmjm530]

Coffee Consumption May Reduce the Risk of Liver Cancer

By Liz Highleyman

Several studies released over the past several years have added to the evidence that coffee may have a beneficial effect on the liver.


As reported in the August 2007 issue of Hepatology, Italian researchers performed a meta-analysis of epidemiologic studies to quantitatively assess the relation between coffee consumption and the risk of liver cancer.

Relevant studies were identified by searching MEDLINE from 1966 through February 2007, and going through the reference lists of retrieved articles. The researchers included cohort and case-control studies that reported relative risk estimates with 95% confidence intervals of primary liver cancer or hepatocellular carcinoma (HCC) by quantitative categories of coffee consumption.

Results

    • 4 cohort studies (from Japan) and 5 case-control studies (from southern Europe and Japan) met the inclusion criteria.

    • Altogether, these studies involved 2260 cases (patients with liver cancer) and 239,146 non-cases (control subjects).

    • All studies observed an inverse relation between coffee consumption and risk of liver cancer, indicating that coffee has a protective effect.

    • In 6 studies, the association was statistically significant.

    • Overall, an increase in consumption of 2 cups of coffee per day was associated with a 43% reduction in the risk of liver cancer (RR 0.57; 95% CI 0.49-0.67).

    • The reduction in risk was greater (55%) for heavy coffee drinkers, and less (30%) for low-to-moderate coffee consumers.

    • In a stratified analysis, the summary relative risks of liver cancer for an increase in consumption of 2 cups of coffee per day were 0.69 (95% CI 0.55-0.87) for people without a history of liver disease and 0.56 (95% CI 0.35-0.91) for those with past liver disease.

    • The association between coffee consumption and liver cancer risk remained even after adjusted for potentially confounding factors including liver cirrhosis, hepatitis B and C, social class, alcohol intake, and smoking status.

Conclusion

In conclusion, the authors wrote, "Findings from this meta-analysis suggest that an increased consumption of coffee may reduce the risk of liver cancer."

However, they cautioned, "The present analysis provides evidence that the inverse relation between coffee and HCC is real, though inference on causality remains open to discussion."

It is unclear why coffee consumption is associated with lower risk of liver cancer, but it may be related to coffee's protective effect with regard to fibrosis and cirrhosis.

http://www.hivandhepatitis.com/hep_c/news/2007/083107_b.html

[robeire]

good articles on herbal research(chinese) here


http://www.itmonline.org/arts/fibrosis.htm
http://www.itmonline.org/arts/hepb.htm
http://www.itmonline.org/arts/chlorogenic.htm
http://www.itmonline.org/arts/salvia.htm
http://www.itmonline.org/arts/turmeri3.htm
http://www.itmonline.org/arts/sparganium.htm

found this valuable-by the way i aint trying to get into a debate about this and i am not trying to promote any products - Rob in ireland ;)

[robeire]

OOps! forgot this article
When I was on tx I took cordyceps and it helped boost my energy levels-
again I aint selling nothing!!
http://www.mycologyresearch.com/pdf/newsletter/newsletter_uk_09.pdf

well wishes from Rob in ireland

[robeire]

REDUCING INFLAMMATION WITH DIET AND SUPPLEMENTS:

The Story of Eicosanoid Inhibition

general review by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

Several important diseases are mediated by production of molecules known as eicosanoids, so named because they are derivatives of the 20-carbon arachidonic acid ("eicos" is from the Greek word eikosi, the number 20; see Figure 1). These diseases include heart attack, asthma, arthritis, ulcerative colitis, asthma, dysmenorrhea, and recurrent headache,

to read full article with diagrams and tables see
http://www.itmonline.org/arts/lox.htm

with every wish from Rob in ireland