Reversibility of Hepatic Fibrosis and Cirrhosis--Is it all Hype?

[mikesimon]

"Now that the idea that hepatic fibrosis is reversible is taking root, many clinicians are beginning to ask why, if fibrosis is reversible, is there so little progress in the clinical setting, and will patients ever really benefit from antifibrotic therapies? Underlying such questions is a subtle cynicism that the reversibility of fibrosis and cirrhosis has been overhyped

[Kalio1]

I think Dominic's post covers it nicely. Im too sick to do research.


thanks a lot for posting this info Dominic.

[EspritLibre1]

Thank you.  Great article, encouraging.  Hope you're well, enjoy your posts.

[mikesimon]

The conclusion stated in the article you cited is:

Conclusion: Sulfasalazine is a potent inhibitor of GCDCA induced hepatocyte apoptosis in vitro and in the intact liver.

Maybe you can see a connection between this conclusion and Sulfasalazine's potential to reverse fibrosis but I can't. I have searched for studies and articles on Sulfasalazine and I can find nothing regarding liver fibrosis other than rat studies - no human studies. I find material on Sulfasalazine and pulmonary function, RA and a few other diseases but nothing about human livers. I would appreciate you posting what you have because this subject interests me greatly.

Mike

[Kalio1]

I agree that drug therapies we hear of are too often spun and reduced to a sound bite making it appear there is a simple answer. I agree that this harms people rather than helps them. While it might service "big pharma" to instigate interest in products, it is not helpful to lead people to believe an easy solution is at hand.

However, with less than a minute devoted to researching  the subject ( a subject I looked into intensely last year , I found this indicating positve effects on intact human livers:

http://gut.bmj.com/cgi/content/abstract/55/5/719?rss=1

and I know I have a number of other studies filed somewhere showing promise using sulfasalazine in humans to reduce liver inflammation/fibrosis including a study that was done on alcoholics that had dramatic results, even in those that were still drinking believe it or not...

While it is important for patients not to be sucked into the "spin" of possible solutions to these issues, it is also important to inform people of the promising solutions that are discovered particularly in a case like sulfasalazine which is an existing drug with tons of studies and research under it's belt having already been done ( it is used for other ailments currently and has been for years), it also is FDA approved and available. It is relatively affordable to boot.( compared to pegintron!) The jury is still out on it's impact on liver fibrosis but it definately warrantsattention and more study and looks very promising. With the situation as it is, with not nearly enough replacement livers to go around, a solution that is already on the market and has little to no side effects is a big plus.

It is no "magic bullet" but it is not true that "only one study on rats" is the basis for the optimism.

To say that like this author of the article does is just spin of a different color.

[GoofyDad]

I read that. My BX report also goes into a discussion about various architectural attributes and whenther or nor they supprt a cirrhosis diagnosis. I've always felt since reading it that, like pies and BMs, there's more to cirrhosis than the crust and the filling.

[andiamo]

My doctor thinks that if portal hypertension develops, it is not reversible, since the blood flow through the liver is inadequate for re-growth.