Yoshiji Hitoshi, Noguchi Ryuichi, Kojima Hideyuki, Ikenaka Yasuhide, Kitade Mitsuteru, Kaji Kosuke, Uemura Masahito, Yamao Junichi, Fujimoto Masao, Yamazaki Masaharu, Toyohara Masahisa, Mitoro Akira, Fukui Hiroshi
Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan.
World J Gastroenterol. 2006 Nov 14;12(42):6786-91. doi: 10.3748/wjg.v12.i42.6786.
To evaluate the effect of combination treatment with the interferon (IFN) and angiotensin-converting enzyme inhibitor (ACE-I) on several fibrotic indices in patients with refractory chronic hepatitis C (CHC).
Perindopril (an ACE-I; 4 mg/d) and/or natural IFN (3 MU/L; 3 times a week) were administered for 12 mo to refractory CHC patients, and several indices of serum fibrosis markers were analyzed.
ACE-I decreased the serum fibrosis markers, whereas single treatment with IFN did not exert these inhibitory effects. However, IFN significantly augmented the effects of ACE-I, and the combination treatment exerted the most potent inhibitory effects. The serum levels of alanine transaminase and HCV-RNA were not significantly different between the groups, whereas the plasma level of transforming growth factor-beta was significantly attenuated almost in parallel with suppression of the serum fibrosis markers.
The combination therapy of an ACE-I and IFN may have a diverse effect on disease progression in patients with CHC refractory to IFN therapy through its anti-fibrotic effect.
评估干扰素(IFN)与血管紧张素转换酶抑制剂(ACE-I)联合治疗对难治性慢性丙型肝炎(CHC)患者多项纤维化指标的影响。
给予难治性CHC患者培哚普利(一种ACE-I;4毫克/天)和/或天然IFN(3百万单位/升;每周3次)治疗12个月,并分析血清纤维化标志物的多项指标。
ACE-I降低了血清纤维化标志物,而单用IFN未产生这些抑制作用。然而,IFN显著增强了ACE-I的作用,联合治疗产生了最有效的抑制作用。各组间丙氨酸转氨酶和HCV-RNA的血清水平无显著差异,而转化生长因子-β的血浆水平几乎与血清纤维化标志物的抑制平行显著降低。
ACE-I与IFN联合治疗可能通过其抗纤维化作用对IFN治疗难治的CHC患者的疾病进展产生多种影响。