Medina Jesús, Moreno-Otero Ricardo
Unidad de Hepatología, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain.
Drugs. 2005;65(17):2445-61. doi: 10.2165/00003495-200565170-00003.
Oxidative stress is a common pathogenetic mechanism contributing to initiation and progression of hepatic damage in a variety of liver disorders. Cell damage occurs when there is an excess of reactive species derived from oxygen and nitrogen, or a defect of antioxidant molecules. Experimental research on the delicately regulated molecular strategies whereby cells control the balance between oxidant and antioxidant molecules has progressed in recent years. On the basis of this evidence, antioxidants represent a logical therapeutic strategy for the treatment of chronic liver disease. Clinical studies with large numbers of patients have not yet been performed. However, results from several pilot trials support this concept and indicate that it may be worth performing multicentre studies, particularly combining antioxidants with anti-inflammatory and/or antiviral therapy. Oxidative stress plays a pathogenetic role in liver diseases such as alcoholic liver disease, chronic viral hepatitis, autoimmune liver diseases and non-alcoholic steatohepatitis. The use of antioxidants (e.g. S-adenosylmethionine [SAMe; ademetionine], tocopherol [vitamin E], polyenylphosphatidylcholine or silymarin) has already shown promising results in some of these pathologies.
氧化应激是导致多种肝脏疾病肝损伤起始和进展的常见发病机制。当源于氧和氮的活性物质过量，或抗氧化分子存在缺陷时，细胞就会受损。近年来，关于细胞如何精细调控氧化还原分子平衡的分子机制的实验研究取得了进展。基于这些证据，抗氧化剂是治疗慢性肝病的合理治疗策略。尚未开展针对大量患者的临床研究。然而，一些初步试验的结果支持这一概念，并表明开展多中心研究可能是值得的，特别是将抗氧化剂与抗炎和/或抗病毒治疗联合使用。氧化应激在酒精性肝病、慢性病毒性肝炎、自身免疫性肝病和非酒精性脂肪性肝炎等肝脏疾病中起致病作用。在其中一些疾病中，使用抗氧化剂（如S-腺苷甲硫氨酸[SAMe；腺苷蛋氨酸]、生育酚[维生素E]、多烯磷脂酰胆碱或水飞蓟宾）已显示出有前景的结果。
