Schierwagen Robert, Uschner Frank Erhard, Magdaleno Fernando, Klein Sabine, Trebicka Jonel
Department of Internal Medicine I, University of Bonn, Germany.
Department of Internal Medicine I, University of Bonn, Germany;
Am J Physiol Gastrointest Liver Physiol. 2017 May 1;312(5):G407-G412. doi: 10.1152/ajpgi.00441.2016. Epub 2017 Mar 9.
The evolution of chronic liver injuries from benign and manageable dysfunction to life threatening end-stage liver disease with severe complications renders chronic liver disease a global health burden. Because of the lack of effective medication, transplantation remains the only and final curative option for end-stage liver disease. Since the demand for organ transplants by far exceeds the supply, other treatment options are urgently required to prevent progression and improve end-stage liver disease. Statins are primarily cholesterol-lowering drugs used for primary or secondary prevention of cardiovascular diseases. In addition to the primary effect, statins act beneficially through different pleiotropic mechanisms on inflammation, fibrosis, endothelial function, thrombosis, and coagulation to improve chronic liver diseases. However, concerns remain about the efficacy and safety of statin treatment because of their potential hepatotoxic risks, and as of now, these risks impede broader use of statins in the treatment of chronic liver diseases. The aim of this review is to comprehensively describe the mechanisms by which statins improve prospects for different chronic liver diseases with special focus on the pathophysiological rationale and the clinical experience of statin use in the treatment of liver diseases.
慢性肝损伤从良性且可控制的功能障碍发展为伴有严重并发症的危及生命的终末期肝病，这使得慢性肝病成为一项全球健康负担。由于缺乏有效的药物，肝移植仍然是终末期肝病唯一且最终的治愈选择。鉴于器官移植的需求远远超过供应，迫切需要其他治疗选择来防止疾病进展并改善终末期肝病。他汀类药物主要是用于心血管疾病一级或二级预防的降胆固醇药物。除了主要作用外，他汀类药物还通过不同的多效性机制对炎症、纤维化、内皮功能、血栓形成和凝血产生有益作用，从而改善慢性肝病。然而，由于他汀类药物存在潜在的肝毒性风险，人们对其治疗的有效性和安全性仍存在担忧，截至目前，这些风险阻碍了他汀类药物在慢性肝病治疗中的更广泛应用。本综述的目的是全面描述他汀类药物改善不同慢性肝病预后的机制，特别关注他汀类药物用于肝病治疗的病理生理原理和临床经验。
