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Research supported antifibrotics - do they exist?

The problems of treatment failure for SOC/IFN nonresponders and the possibility of reducing future supercombo-SVRchances by introducing archived resistance mutations when using "Pseudomonotherapy" - (that is here defined as using  a single  antiviral agent that is not protected against resistance development by its combo with an IFN/riba component (IFN by definition in this scenario is not sufficiently effective in reducing viral replication so that all the burden to tame the adaptive quasispecies evolution falls on the antiviral)) together with the 61% and 65% SVR rates for the latest triple modality in Geno 1s, have raised concern and the awareness for the need for alternate/additional treatment modalities in many HCV patients and their health care providers. Waiting for future antiviral developments is one route frequently recommended, but for the patients  in current need, our repertoire of additional meaningful approaches needs to be carefully reevaluated. Using antifibrotics to halt fibrosis progression is one concept not proven in large trials but it might well be effective in many, because the mechanisms for fibrosis generation are not intrinsically linked to HCV persistence, but rather to secondary response mechanisms evoked in the chronically inflamed liver, with the stellate cell activation holding center stage in this scenario. The following is one of several possible add on modalities.
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Avatar universal
MEDICAL PROFESSIONAL
whrose:
my question is this...how does one evaluate the true ingredients and bioavailabilty of PPC products? there are so many scams out there.

Yes and confusing the identity of one compound with the other by making it all "choline". Thaty why I indicated the one thats pure pharmaceutical quality PPC. There might be others offering the same, but I did not scan the vitamin market for that.

There is no FDA approved multicomponent antifibrotic therapy for advanced  fibrosis HCV patients with treatment failure in current or near future existence.Long term PegInterferon was just shown at the AASLD to be not effective.. So nothing can be recommended in a place like this. That does not mean that a combination of hepatocyte protective, inflammation protective measures/agents and ,very much in particular, stellate transdifferentiation signaling blocking +otherwise proven nontoxic agents are not likely to be effective in that regard. I spent 3 hours at the AASLD to explain those concepts and their practical applications to one individual in particular need. I can point to literature and specific concepts and some aspects of practical application here from time to time in a piecemeal fashion, which has been done and was mainly lost. I can say that the use of various internet liver protective websites is - with some proper information interspersed - mainly futile and totally confusing, possibly wiping out the few specifically effective components that a person was already using. Look at goofydad : He forgets his Same. But at least he takes his Resveratrol....
Avatar universal
dang...whats a compliant and serious consumer to do when evaluating a products claims.
when i visit a health food store i get overwelmed by the products let alone the web! the info given is usually by another ignorant expert. most sites have an expert doctor (usually a chiro into "natural" cures giving alot of unproven hype. often this has me saying good bye to the products.
i  need the biochemical evidence of a product as much as i need to know its purity and effectiveness.
i wish i were there in your 3 hour discussion at AASLD!

thanks  Whrose
92903 tn?1309904711
Duly reprimanded :)

And I forgot to mention the green tea extract too - which IIRC was presented in a study at last year's pilgrimage of the liverheads....
Avatar universal
MEDICAL PROFESSIONAL
Yes, well remembered from the last years liverheads pilgrimage- the green tea posters ( not the posters here, but the presentation at the AASLD 2006 in poster format) re its antifibrotic effects.

It is of course one of the legs/prongs/components I would like to be considered in the antifibrotic regimen that the various practitioners should recommend to their patients. We do not know what works best, I am eagerly looking for comparison of the various in vitro/animal model antifibrotic effects of the promising compounds - but that has not been done.

Note that the extrapolation towards an expected in vivo human effect from an in vitro study that examines eg Tumor growth factor beta one or Nuclear factor beta expression supressive effects in stellate cell cultures is difficult since the concentrations used in viitro and the actual concentratin that you can realistically achieve in the liver by x dosage can be very very different.

Also note that there are quite a few substances that are so nontoxic - like green tea - the FDA expression is GRAS (Generally Regarded As Safe) that taking fairly high amounts in order not to miss a possibly critical contribution to the overall antifibrotic effect is likely a sound and overall effective practice. Always assuming of course that your personal doctor knows about it and approves it. Not a bad idea, to ask him if he is aware of all the respective work regarding these substances, including toxicity studies, antifibrotic in vitro and in vivo trials and other important work that sheds light on the possible health or ill effects of a particular substance. To scan and digest the antifibrotic presentations at each years AASLD alone takes many, many hours and I would seriously suggest that much more time will be allotted for this poster viewing, to give at least a working chance to the conference attending practitionrs to get aquainted with this research and its potential practical consequences.
Avatar universal
i did a quick take on dosage for PPC. read therapeutic range of intake is 800-2400 mg daily, and 4-6 grams or higher for liver salvage. in your view what would be a therapeutic range for cirrhosis. note that hepatopro comes in 900 mg caps with instructions to take bid.

YES i wish that our treatment docs would spend more time scanning and digesting anti fibrotic regimes. most of the people i know are taking measures on their own in a hit and hope loop. i would like to see docs giving "prescription strength advice" to our hi fibrotic population. this is more important than ever as our greatest population of infection are with midlifers, with some having little time to wait for combos way down the road. i am heartened that you have interest in this arena and  privileged to have your wisdom.
92903 tn?1309904711
i did a quick take on dosage for PPC. read therapeutic range of intake is 800-2400 mg daily, and 4-6 grams or higher for liver salvage.

Have you got any links????
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