Shimizu I, Omoya T, Takaoka T, Wada S, Wada H, Taoka M, Hayashi H, Hayashi S, Honda H, Sano N, Ito S
Second Department of Internal Medicine, Tokushima University School of Medicine, Japan.
J Gastroenterol Hepatol. 2001 Feb;16(2):196-201. doi: 10.1046/j.1440-1746.2001.02402.x.
It has been reported that chronic infection with hepatitis C virus is associated with excess iron deposits in the liver of subjects who are neither alcoholics nor recipients of blood transfusions. However, little is known about the relationship between hepatic iron concentration (HIC) and the serum levels of hepatic fibrogenesis markers, which were caused by interferon therapy for chronic hepatitis C. Therefore, changes in the serum amino-terminal propeptide of type III procollagen (P-III-P) and the 7S domain of type IV collagen (7S-IV) in 16 patients treated with alpha-interferon (IFN-alpha) were studied, and their HIC and histological assessment evaluated. Hepatic iron concentrations were measured by using liver biopsy specimens obtained before and 6 months after the cessation of treatment.
Eight subjects (50%) who had normal alanine transaminase levels at 6 months after therapy showed significantly lowered HIC, and attenuated hepatic iron staining with decreased serum levels of P-III-P and 7S-IV compared to the remaining subjects. The HIC was significantly correlated with the serum levels of P-III-P and 7S-IV in all subjects.
These findings suggest that IFN-alpha treatment may decrease stimuli for fibrogenesis, at least in part, by reducing the hepatic iron deposition in patients with chronic hepatitis C.
据报道,在既非酗酒者也非输血受者的人群中,丙型肝炎病毒慢性感染与肝脏中铁过量沉积有关。然而,关于慢性丙型肝炎干扰素治疗引起的肝铁浓度(HIC)与肝纤维化标志物血清水平之间的关系,人们知之甚少。因此,研究了16例接受α干扰素(IFN-α)治疗的患者血清III型前胶原氨基端前肽(P-III-P)和IV型胶原7S结构域(7S-IV)的变化,并评估了他们的HIC和组织学情况。通过使用治疗停止前和停止后6个月获得的肝活检标本测量肝铁浓度。
与其余受试者相比,8名(50%)在治疗6个月时丙氨酸转氨酶水平正常的受试者显示HIC显著降低,肝铁染色减弱,血清P-III-P和7S-IV水平降低。在所有受试者中,HIC与血清P-III-P和7S-IV水平显著相关。
这些发现表明,IFN-α治疗可能至少部分通过减少慢性丙型肝炎患者的肝铁沉积来减少纤维化刺激。