1
|
Lozano-Sepúlveda SA, Rincón-Sanchez AR, Rivas-Estilla AM. Antioxidants benefits in hepatitis C infection in the new DAAs era. Ann Hepatol 2020; 18:410-415. [PMID: 31122787 DOI: 10.1016/j.aohep.2019.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 02/04/2023]
Abstract
Some of the evidence on whether antioxidant supplements are effective in treatment of liver diseases is contradictory. Here we perform a descriptive analysis of the available data in vivo and in vitro of the possible antiviral action and controversy of several antioxidant molecules against HCV.
Collapse
Affiliation(s)
- Sonia A Lozano-Sepúlveda
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose Eluterio Gonzalez", Department of Biochemistry and Molecular Medicine, Monterrey, Nuevo Leon, Mexico
| | - Ana R Rincón-Sanchez
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico
| | - Ana M Rivas-Estilla
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. Jose Eluterio Gonzalez", Department of Biochemistry and Molecular Medicine, Monterrey, Nuevo Leon, Mexico.
| |
Collapse
|
2
|
Gonçalves D, Lima C, Ferreira P, Costa P, Costa A, Figueiredo W, Cesar T. Orange juice as dietary source of antioxidants for patients with hepatitis C under antiviral therapy. Food Nutr Res 2017; 61:1296675. [PMID: 28469541 PMCID: PMC5404424 DOI: 10.1080/16546628.2017.1296675] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 01/30/2017] [Indexed: 02/08/2023] Open
Abstract
Background: HCV causes alterations in liver metabolism, resulting in biochemical and nutritional disorders. Supplementation with antioxidants has been suggested to minimize the diseases effects. Objective: This study assessed whether orange juice, a source of citrus flavonoids and vitamin C, may contribute to the treatment of patients with chronic hepatitis C. Design: Anthropometric, hemodynamic, dietary, and biochemical parameters, CRP and liver enzymes were measured in 43 adult patients of both genders who were diagnosed with chronic hepatitis C and were under antiviral therapy. Twenty-three patients were supplemented with orange juice for eight consecutive weeks, while 20 were enrolled as control group. Results: Following regular use of orange juice, no alterations were found in body mass, fat, and waist circumference. The serum levels of total cholesterol, LDL-cholesterol, CRP and parameters of oxidative stress decreased in the orange juice group. Furthermore, the levels of the liver enzyme AST decreased in those who had high levels before the intervention. Conclusion: The orange juice was a convenient food in the diet of patients due to the increase in antioxidant capacity and decreased inflammation and cholesterol in blood serum, in addition to maintaining body mass, which protect against the harmful effects caused by the chronic hepatitis C virus.
Collapse
Affiliation(s)
- Danielle Gonçalves
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Claudia Lima
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Paula Ferreira
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Paulo Costa
- Clinical Analysis Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| | - Angela Costa
- Special Health Service of Araraquara (SESA), Faculty of Public Health, Universidade de Sao Paulo (USP), Araraquara, Brazil
| | - Walter Figueiredo
- Special Health Service of Araraquara (SESA), Faculty of Public Health, Universidade de Sao Paulo (USP), Araraquara, Brazil
| | - Thais Cesar
- Food and Nutrition Department, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), Araraquara, Brazil
| |
Collapse
|
3
|
Lozano-Sepulveda SA, Bryan-Marrugo OL, Cordova-Fletes C, Gutierrez-Ruiz MC, Rivas-Estilla AM. Oxidative stress modulation in hepatitis C virus infected cells. World J Hepatol 2015; 7:2880-2889. [PMID: 26692473 PMCID: PMC4678374 DOI: 10.4254/wjh.v7.i29.2880] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/19/2015] [Accepted: 12/02/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) replication is associated with the endoplasmic reticulum, where the virus can induce cellular stress. Oxidative cell damage plays an important role in HCV physiopathology. Oxidative stress is triggered when the concentration of oxygen species in the extracellular or intracellular environment exceeds antioxidant defenses. Cells are protected and modulate oxidative stress through the interplay of intracellular antioxidant agents, mainly glutathione system (GSH) and thioredoxin; and antioxidant enzyme systems such as superoxide dismutase, catalase, GSH peroxidase, and heme oxygenase-1. Also, the use of natural and synthetic antioxidants (vitamin C and E, N-acetylcysteine, glycyrrhizin, polyenylphosphatidyl choline, mitoquinone, quercetin, S-adenosylmethionine and silymarin) has already shown promising results as co-adjuvants in HCV therapy. Despite all the available information, it is not known how different agents with antiviral activity can interfere with the modulation of the cell redox state induced by HCV and decrease viral replication. This review describes an evidence-based consensus on molecular mechanisms involved in HCV replication and their relationship with cell damage induced by oxidative stress generated by the virus itself and cell antiviral machinery. It also describes some molecules that modify the levels of oxidative stress in HCV-infected cells.
Collapse
|
4
|
Arain SQ, Talpur FN, Channa NA. A comparative study of serum lipid contents in pre and post IFN-alpha treated acute hepatitis C patients. Lipids Health Dis 2015; 14:117. [PMID: 26403989 PMCID: PMC4582939 DOI: 10.1186/s12944-015-0119-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/14/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To study the effect of Interferon (INF) alpha-2b therapy on the serum lipids and fatty acid (FA) level in pre and post treated hepatitis C (HCV) patients. METHODS Fifty samples were collected from pre and post treated patients along with age and gender matched controls. After separating serum, lipid contents were analyzed by microlab and gas chromatography. RESULTS The hepatitis C infection results in hypolipidemia with reduced level of triglyceride (113 mg/dl), high density lipoprotein (37.1 mg/dl), low density lipoprotein (74.3 mg/dl), cholesterol (149.9 mg/dl) that increase the infection resolution and after the IFN treatment, the lipid profile of the patients were increased. The myristic (2.8 g/100 g) and palmitic acids (26.6 g/100 g) were significantly higher while linoleic acid (20.94 g/100 g) was significantly lower in HCV patients. The higher oleic: stearic (1.4) and palmitoleic: palmitic acid (0.2) ratios were detected in HCV patients, showing enhanced stearoyl-CoA desaturase activity. The levels of serum saturated (44.9 g/100 g) and monounsaturated FA's (26.98 g/100 g) were higher while polyunsaturated FA's (25.9 g/100 g) were found lower in HCV patients in comparison of controls (40.1; 25.01; 33.44 g/100 g respectively). An inverse correlation was found HCV RNA viral load and PUFA (R(2) = 0.4555). Elevated levels of serum saturated free FA (45.7 g/100 g) in HCV patients indicates stimulated lipoapoptosis. CONCLUSION The present study conclude that serum PUFA level was lower in HCV patients, hence PUFA may provide synergistic antiviral effects when given as a food supplement during the INF based anti- HCV therapy.
Collapse
Affiliation(s)
- Sadia Qamar Arain
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.,Institute of Biochemistry University of Sindh, Jamshoro, Pakistan
| | - Farah Naz Talpur
- National Centre of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76080, Pakistan.
| | | |
Collapse
|
5
|
Pereira MC, Steffens RS, Jablonski A, Hertz PF, Rios ADO, Vizzotto M, Flôres SH. Characterization, bioactive compounds and antioxidant potential of three Brazilian fruits. J Food Compost Anal 2013. [DOI: 10.1016/j.jfca.2012.07.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
6
|
El-Kannishy G, Arafa M, Abdelaal I, Elarman M, El-Mahdy R. Persistent oxidative stress in patients with chronic active hepatitis-C infection after antiviral therapy failure. Saudi J Gastroenterol 2012; 18:375-9. [PMID: 23150023 PMCID: PMC3530992 DOI: 10.4103/1319-3767.103429] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/AIMS Oxidative stress and hepatocellular pathological changes are common associations with chronic hepatitis C virus (CHC) disease. The aim of this study was to assess serum antioxidant-oxidant (Redox) balance in patients with CHC infection before and after intake of the traditional antiviral therapy (pegylated interferon α-2b and oral ribavirin). PATIENTS AND METHODS Blood samples from 50 biopsy-proven CHC patients, with no prior anti-viral treatment and persistently elevated serum transaminase levels for 6 months, as well as 15 age- and sex-matched healthy subjects were used for determination of the antioxidants: reduced glutathione (GSH), superoxide dismutase (SOD), α tocopherol and ascorbic acid as well as lipid peroxidation (LPO) index (malondialdehyde [MDA]). The measurements were repeated in the diseased group 25 weeks after pegylated interferon α-2b and ribavirin combination therapy. RESULTS Serum levels of bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly higher in CHC patients than in the control group (P < 0.05). Pretreatment serum MDA values were significantly higher in patients with CHC infection than the control group (P < 0.001), while serum antioxidant levels were significantly lower (P < 0.001). Responders (10 patients) had lower pretreatment serum levels of MDA than non-responders (35 patients) (P < 0.001). Both groups were comparable for the antioxidant serum levels. There was significant negative correlation between serum MDA and serum SOD, GSH, α tocopherol, and ascorbic acid concentrations in CHC patients. On the other hand, there was no correlation between the studied parameters and serum bilirubin, albumin, ALT, and AST. CONCLUSIONS Redox imbalance was detected in patients with CHC. Responders had significantly lower levels of MDA than non-responders. Serum MDA may be used as a pretreatment predictor of response to antiviral treatment in patients with CHC.
Collapse
Affiliation(s)
- Ghada El-Kannishy
- Department of Internal Medicine, Faculty of Medicine, Mansoura University, Egypt,Address for correspondence: Dr. Ghada El-Kannishy, Department of Internal Medicine, Faculty of Medicine, Endocrinology Unit, Mansoura University Hospital, Mansoura, Egypt. E-mail:
| | - Mona Arafa
- Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Egypt
| | - Ibrahim Abdelaal
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt
| | - Mohamed Elarman
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt
| | - Rasha El-Mahdy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt
| |
Collapse
|
7
|
Irmisch G, Hoeppner J, Thome J, Richter J, Fernow A, Reisinger EC, Lafrenz M, Loebermann M. Serum fatty acids, antioxidants, and treatment response in hepatitis C infection: greater polyunsaturated fatty acid and antioxidant levels in hepatitis C responders. J Clin Lipidol 2011; 5:288-93. [PMID: 21784374 DOI: 10.1016/j.jacl.2011.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 04/11/2011] [Accepted: 04/20/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patients suffering from chronic hepatitis C (CHC) may exhibit impaired liver functions such as disturbances of fatty acid storage, synthesis and degradation. OBJECTIVE Possible associations between serum fatty acid (SFA) profiles, antioxidant status and treatment response were investigated in a trans-sectional study of untreated and treated CHC patients in comparison to a healthy control group. METHODS SFA composition and antioxidant status were examined in female patients with CHC: 9 were naïve to Interferon-α and ribavirin treatment (IFR), 21 sustained treatment responders, 21 were nonresponders, and 21 were healthy control group members. Additionally, in all CHC patients gammaglutamyl transferase (GGT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured. RESULTS Responders and healthy control group members had significantly higher antioxidant (P < .001), eicosapentaenoic (P < .001) and arachidonic acid (P < .004) levels, but lower stearic acid (P < .001) concentrations than non-responders and untreated patients. ALT was higher in untreated CHC patients than in treated ones (P < .028). GGT and AST did not differ significantly between patient groups, however GGT levels were associated with serum Gamma-Linolenic-Acid concentration (P = .009). CONCLUSION SFA profiles and antioxidant status in female CHC patients differ markedly from those of healthy controls, a phenomenon which is possibly related with their effect of HCV replication.
Collapse
Affiliation(s)
- Gisela Irmisch
- Department of Psychiatry and Psychotherapy, University of Rostock, Gehlsheimer Str. 20, D-18147 Rostock, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Bjelakovic G, Gluud LL, Nikolova D, Bjelakovic M, Nagorni A, Gluud C. Antioxidant supplements for liver diseases. Cochrane Database Syst Rev 2011:CD007749. [PMID: 21412909 DOI: 10.1002/14651858.cd007749.pub2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Several liver diseases have been associated with oxidative stress. Accordingly, antioxidants have been suggested as potential therapeutics for various liver diseases. The evidence supporting these suggestions is equivocal. OBJECTIVES To assess the benefits and harms of antioxidant supplements for patients with liver diseases. SEARCH STRATEGY We searched The Cochrane Library, MEDLINE, EMBASE, LILACS, the Science Citation Index Expanded, and Conference Proceedings Citation Index-Science to January 2011. We scanned bibliographies of relevant publications and asked experts and pharmaceutical companies for additional trials. SELECTION CRITERIA We considered for inclusion randomised trials that compared antioxidant supplements (beta-carotene, vitamin A, C, E, and selenium) versus placebo or no intervention for autoimmune liver diseases, viral hepatitis, alcoholic liver disease, and cirrhosis (any aetiology). DATA COLLECTION AND ANALYSIS Four authors independently selected trials for inclusion and extracted data. Outcome measures were all-cause mortality, liver-related mortality, liver-related morbidity, biochemical indices at maximum follow-up in the individual trials as well as adverse events, quality-of-life measures, and cost-effectiveness. For patients with hepatitis B or C we also considered end of treatment and sustained virological response. We conducted random-effects and fixed-effect meta-analyses. Results were presented as relative risks (RR) or mean differences (MD), both with 95% confidence intervals (CI). MAIN RESULTS Twenty randomised trials with 1225 participants were included. The trials assessed beta-carotene (3 trials), vitamin A (2 trials), vitamin C (9 trials), vitamin E (15 trials), and selenium (8 trials). The majority of the trials had high risk of bias and showed heterogeneity. Overall, the assessed antioxidant supplements had no significant effect on all-cause mortality (relative risk [RR] 0.84, 95% confidence interval [CI] 0.60 to 1.19, I(2) = 0%), or liver-related mortality (RR 0.89, 95% CI 0.39 to 2.05, I(2) = 37%). Stratification according to the type of liver disease did not affect noticeably the results. Antioxidant supplements significantly increased activity of gamma glutamyl transpeptidase (MD 24.21 IU/l, 95% CI 6.67 to 41.75, I(2) = 0%). AUTHORS' CONCLUSIONS We found no evidence to support or refute antioxidant supplements in patients with liver disease. Antioxidant supplements may increase liver enzyme activity.
Collapse
Affiliation(s)
- Goran Bjelakovic
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344, Rigshospitalet, Copenhagen University Hospital, and Department of Internal Medicine - Gastroenterology and Hepatology, Medical Faculty, University of Nis, Zorana Djindjica 81, Nis, Serbia, 18000
| | | | | | | | | | | |
Collapse
|
9
|
Abstract
BACKGROUND AND AIM Current practice guidelines recommend that individuals chronically infected with the hepatitis C virus (HCV) be treated with pegylated interferon plus ribavirin. Ribavirin, however, is associated with serious adverse events (AE), especially anemia. We review its mechanism of action, its importance in treating chronic hepatitis C (CHC) patients, the AE associated with its use, and techniques used to lessen these AE. METHODS Medline searches were performed using the keywords ribavirin and hepatitis, together with the keywords mechanism, anemia, liver transplant, renal function, pharmacokinetics, and dose reduction. Searches of abstracts of recent Digestive Diseases Week, American Association for the Study of Liver Diseases, and European Association for the Study of Liver Diseases meetings were also performed. RESULTS Ribavirin may be effective in treating CHC by affecting the virus or the host; for example by inducing viral mutations, blocking cellular enzymes, or affecting the host immune response. Although the pegylated interferons are the primary drugs used to treat CHC, a combination with ribavirin is more effective than pegylated interferon alone. Ribavirin-associated AE may be lessened by ribavirin dose reductions and by maintenance of the hematocrit. CONCLUSIONS Treatments of ribavirin toxicities, especially anemia, can allow patients to continue full-dose combination therapy with peginterferon and ribavirin, enhancing their probability of attaining a sustained virologic response (SVR). Treatment of CHC should be tailored to individual patients, especially those with renal dysfunction, and should include agents that treat the side-effects of CHC treatment. Monitoring of plasma ribavirin concentrations during treatment may help in the future.
Collapse
|
10
|
Kawashima A, Tsukamoto I, Koyabu T, Murakami Y, Kawakami T, Kakibuchi N, Takaguchi K, Kita K, Okita M. Eicosapentaenoic Acid Supplementation for Chronic Hepatitis C Patients During Combination Therapy of Pegylated Interferon α-2b and Ribavirin. Lipids 2008; 43:325-33. [DOI: 10.1007/s11745-008-3157-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Accepted: 01/25/2008] [Indexed: 02/05/2023]
|
11
|
Murakami Y, Koyabu T, Kawashima A, Kakibuchi N, Kawakami T, Takaguchi K, Kita K, Okita M. Zinc supplementation prevents the increase of transaminase in chronic hepatitis C patients during combination therapy with pegylated interferon alpha-2b and ribavirin. J Nutr Sci Vitaminol (Tokyo) 2007; 53:213-8. [PMID: 17874825 DOI: 10.3177/jnsv.53.213] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We investigated the effects of zinc supplementation on clinical observations in chronic hepatitis C patients receiving pegylated interferon (PEG-IFN) alpha-2b plus ribavirin combination therapy. Patients were randomly allocated to receive 150 mg polaprezinc (zinc group, n=11) or no supplement (control group, n=12) daily in addition to PEG-IFN alpha-2b plus ribavirin therapy and 300 mg vitamin E and 600 mg vitamin C supplementation daily for 48 wk. Among the patients who continued treatment, the serum alanine aminotransferase (ALT) level at 12 wk in the zinc group was significantly lower than that in the control group. All patients in the zinc group (9/9) and 67% (8/12) of the control patients at 24 wk, and all patients in the zinc group (7/7) and 60% (6/10) of the control patients at 48 wk showed a decrease in serum ALT levels to within the normal range (7-44 U/L). HCV RNA disappeared in all patients (7/7) in the zinc group and in 8 of 10 control patients at 48 wk. Polaprezinc supplementation decreased plasma thiobarbituric acid reactive substances and prevented the decrease of polyunsaturated fatty acids of erythrocyte membrane phospholipids. No significant differences were observed in the dosage of medicines or other clinical data during the treatment. These observations indicate that polaprezinc supplementation may have induced some antioxidative functions in the liver which resulted in reduced hepatocyte injury during PEG-IFN alpha-2b plus ribavirin therapy.
Collapse
Affiliation(s)
- Yasuko Murakami
- Department of Nutritional Science, Faculty of Health and Welfare Science, Okayama Prefectural University, Okayama 719-1197, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Di Sario A, Candelaresi C, Omenetti A, Benedetti A. Vitamin E in chronic liver diseases and liver fibrosis. VITAMINS AND HORMONES 2007; 76:551-73. [PMID: 17628189 DOI: 10.1016/s0083-6729(07)76021-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Liver fibrosis may be considered as a dynamic and integrated cellular response to chronic liver injury. The activation of hepatic stellate cells and the consequent deposition of large amounts of extracellular matrix play a major role in the fibrogenic process, but it has been shown that other cellular components of the liver are also involved. Although the pathogenesis of liver damage usually depends on the underlying disease, oxidative damage of biologically relevant molecules might represent a common link between different forms of chronic liver injury and hepatic fibrosis. In fact, oxidative stress-related molecules may act as mediators able to modulate all the events involved in the progression of liver fibrosis. In addition, chronic liver diseases are often associated with decreased antioxidant defenses. Although vitamin E levels have been shown to be decreased in chronic liver diseases of different etiology, the role of vitamin E supplementation in these clinical conditions is still controversial. In fact, the increased serum levels of alpha-tocopherol following vitamin E supplementation not always result in a protective effect on liver damage. In addition, clinical trials have usually been performed in small cohorts of patients, thus making definitive conclusions impossible. At present, treatment with vitamin E or other antioxidant compounds could be proposed for nonalcoholic fatty liver disease (NAFLD), the most frequent hepatic lesion in western countries which can progress to nonalcoholic steatohepatitis and cirrhosis due to the production of large amounts of oxidative stress products. However, although some studies have shown encouraging results, multicentric and long-term clinical trials are needed.
Collapse
Affiliation(s)
- Antonio Di Sario
- Department of Gastroenterology, Università Politecnica delle Marche, Polo Didattico III, Piano, Via Tronto 10, 60020 Torrette, Ancona, Italy
| | | | | | | |
Collapse
|
13
|
Levent G, Ali A, Ahmet A, Polat EC, Aytaç Ç, Ayşe E, Ahmet S. Oxidative stress and antioxidant defense in patients with chronic hepatitis C patients before and after pegylated interferon alfa-2b plus ribavirin therapy. J Transl Med 2006; 4:25. [PMID: 16787540 PMCID: PMC1513604 DOI: 10.1186/1479-5876-4-25] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Accepted: 06/20/2006] [Indexed: 12/11/2022] Open
Abstract
Background Oxidative stress could play a role in pathogenesis of hepatitis C virus (HCV) infection. The aim of our study is to determine oxidant/antioxidant status of patients with chronic hepatitis C (CHC), and the effect of pegylated interferon alfa-2b plus ribavirin combination therapy on oxidative stress. Methods Nineteen patients with chronic HCV infection and 28 healthy controls were included in the study. In control and patient groups, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, erythrocyte malondialdehyde (MDA) levels, erythrocyte CuZn-superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GSH-Px) activities were measured. After pegylated interferon alfa-2b and ribavirin combination therapy for 48 weeks, these parameters were measured again in the patient group. Results Serum MDA levels increased significantly in CHC patients (n:19), before the treatment when compared with healthy subjects (n:28) 9.28 ± 1.61, 4.20 ± 1.47 nmol/ml, p < 0.001 respectively. MDA concentration decreased significantly (p < 0.001) after the treatment as well as ALT, AST activity, in erythrocytes of these patients. Average antioxidant enzymes (superoxide dismutase and glutathione peroxidase) were significantly lower in erythrocytes of patients with CHC before treatment compared with the control group (both, p < 0.001). Chronic Hepatitis C patients after pegylated interferon alfa-2b and ribavirin therapy showed values of SOD, GSH-Px were significantly higher than pretreatment levels (both, p < 0.001). Conclusion Our results show that patients with chronic HCV infection are under the influence of oxidative stress associated with lower levels of antioxidant enzymes. These impairments return to level of healthy controls after pegylated interferon alfa-2b plus ribavirin combination therapy of CHC patients. Although interferon and ribavirin are not antioxidants, their antiviral capacity might reduce viral load, and inflammation, and perhaps through this mechanism might reduce virus-induced oxidative stress.
Collapse
Affiliation(s)
- Görenek Levent
- Gülhane Military Medical Academy, Department of Infectious Diseases and Clinic Microbiology, 06018, Etlik, Ankara, Turkey
| | - Acar Ali
- Gülhane Military Medical Academy, Department of Infectious Diseases and Clinic Microbiology, 06018, Etlik, Ankara, Turkey
| | - Aydın Ahmet
- Gülhane Military Medical Academy, Department of Toxicology, Ankara, Turkey
| | - Eyigun Can Polat
- Gülhane Military Medical Academy, Department of Infectious Diseases and Clinic Microbiology, 06018, Etlik, Ankara, Turkey
| | - Çetinkaya Aytaç
- Gülhane Military Medical Academy, Department of Infectious Diseases and Clinic Microbiology, 06018, Etlik, Ankara, Turkey
| | - Eken Ayşe
- Gülhane Military Medical Academy, Department of Toxicology, Ankara, Turkey
| | - Sayal Ahmet
- Gülhane Military Medical Academy, Department of Toxicology, Ankara, Turkey
| |
Collapse
|