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慢性丙型肝炎患者接受α干扰素治疗后血清基质金属蛋白酶-1组织抑制剂的变化

Changes in serum tissue inhibitor of matrix metalloproteinase-1 after interferon alpha treatment in chronic hepatitis C.

作者信息

Mitsuda A, Suou T, Ikuta Y, Kawasaki H

机构信息

Second Department of Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan.

出版信息

J Hepatol. 2000 Apr;32(4):666-72. doi: 10.1016/s0168-8278(00)80230-5.

Abstract

BACKGROUND/AIMS: The aim of this study was to evaluate the effect of interferon alpha on the metabolism of hepatic fibrosis in chronic hepatitis C, monitoring serum tissue inhibitor of matrix metalloproteinase-1(TIMP-1) and N-terminal propeptide of type III procollagen (PIIINP) reflecting fibrolysis and fibrogenesis, respectively.

METHODS

Serum levels of TIMP-1 and PIIINP were serially measured in 112 treated and 31 untreated patients with chronic hepatitis C during and after interferon alpha treatment. Furthermore, the relationships between these serum markers and the grades of hepatic fibrosis after interferon therapy were also investigated.

RESULTS

Serum pretreatment levels of TIMP-1 and PIIINP in non-responders were significantly higher than those in sustained and transient responders, but these levels were not different in the latter two groups. Serum TIMP-1 levels decreased significantly during and after treatment in sustained responders, and decreased temporarily at the end of treatment in transient responders, although these levels were unchanged during and after treatment in non-responders and untreated patients. In contrast, serum PIIINP levels decreased significantly during and after treatment in all treated groups, but were unchanged in untreated patients. Histological examination 12 months after interferon was completed demonstrated that hepatic fibrosis improved in sustained responders and was unchanged in transient and non-responders, but progressed in untreated patients.

CONCLUSION

These results suggest that interferon alpha treatment of chronic hepatitis C may improve hepatic fibrosis in sustained responders by the acceleration of fibrolysis as well as the inhibition of fibrogenesis, and that it may suppress the progression of hepatic fibrosis in non-sustained responders by the inhibition of fibrogenesis.

摘要

背景/目的:本研究旨在评估α干扰素对慢性丙型肝炎肝纤维化代谢的影响,监测分别反映纤维溶解和纤维生成的血清基质金属蛋白酶-1组织抑制剂(TIMP-1)和III型前胶原N端前肽(PIIINP)。

方法

对112例接受治疗和31例未接受治疗的慢性丙型肝炎患者在α干扰素治疗期间及治疗后连续检测血清TIMP-1和PIIINP水平。此外,还研究了这些血清标志物与干扰素治疗后肝纤维化分级之间的关系。

结果

无应答者的血清TIMP-1和PIIINP预处理水平显著高于持续应答者和短暂应答者,但后两组之间这些水平无差异。持续应答者在治疗期间及治疗后血清TIMP-1水平显著下降,短暂应答者在治疗结束时暂时下降,而无应答者和未治疗患者在治疗期间及治疗后这些水平无变化。相比之下,所有治疗组在治疗期间及治疗后血清PIIINP水平均显著下降,但未治疗患者的血清PIIINP水平无变化。干扰素治疗完成12个月后的组织学检查表明,持续应答者的肝纤维化得到改善,短暂应答者和无应答者的肝纤维化无变化,但未治疗患者的肝纤维化进展。

结论

这些结果表明,α干扰素治疗慢性丙型肝炎可能通过加速纤维溶解以及抑制纤维生成来改善持续应答者的肝纤维化,并且可能通过抑制纤维生成来抑制非持续应答者肝纤维化的进展。

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