Jiménez-Luévano Miguel Ángel, Jiménez-Partida Ana Emilia, Sierra-Díaz Erick, Orozco-Alonso Eduardo, Villaseñor-García Martha, Bravo-Hernández Alejandro, Gutiérrez-Ortíz Jesús Alejandro, Bravo-Cuellar Alejandro, Hernández-Flores Georgina
Gastroenterology Service, Institute for Security and Social Services for State Workers, Valentín Gómez Farías General Hospital, Zapopan, Jalisco 45100, Mexico.
Division of Immunology, Western Biomedical Research Center, Mexican Social Security Institute, Guadalajara, Jalisco 44340, Mexico.
Biomed Rep. 2024 Sep 23;21(6):173. doi: 10.3892/br.2024.1861. eCollection 2024 Dec.
Liver cirrhosis is a pathology of varied etiology with a high prevalence and mortality, resulting in >1 million mortalities per year. Patients with liver cirrhosis typically have a survival time of 12 years following diagnosis. The treatment for this disease is directed at the complications of cirrhosis; however, to the best of our knowledge, the long-term management of patients with cirrhosis has been scarcely studied. Pentoxifylline (PTX) is a non-selective phosphodiesterase inhibitor with rheological activity and antioxidant, anti-inflammatory and antifibrotic properties. PTX has been used in the treatment of peripheral arterial disease, inflammatory liver diseases and hepatocellular carcinoma with encouraging results. The aim of the present study was to evaluate the effect of PTX use on the survival of patients with compensated cirrhosis. For this purpose, a cross-sectional study was performed at the Gastroenterology and Hepatitis C Department of Dr. Valentín Gómez Farias Hospital (Institute for Security and Social Services for State Workers, Zapopan, Mexico) from June, 1996 to December, 2019. The follow-up time for these patients was 22.6 years (up to the end of the study period). In the present study, 326 patient files were analyzed and 118 patients with the disease were identified, 81 of whom (68.64%) died within 12 years after diagnosis. Of the included patients, 26 received PTX combined with PEG IFN-α-2a plus ribavirin, and 11 received PTX plus propranolol, with a median treatment duration of 20.6±0.8 years. Furthermore, 16 patients (43%) did not develop co-morbidities within this time, and the transition to decompensated cirrhosis was 16.6 years, with a survival time of 20 years. Therefore, the results of the present study suggest that PTX may improve the long-term survival of patients with compensated cirrhosis, rendering PTX a candidate for repurposing in the treatment of hepatic cirrhosis.
肝硬化是一种病因多样的疾病，患病率和死亡率都很高，每年导致超过100万人死亡。肝硬化患者确诊后的存活时间通常为12年。这种疾病的治疗针对肝硬化的并发症；然而，据我们所知，肝硬化患者的长期管理几乎没有得到研究。己酮可可碱（PTX）是一种非选择性磷酸二酯酶抑制剂，具有流变学活性以及抗氧化、抗炎和抗纤维化特性。PTX已被用于治疗外周动脉疾病、炎症性肝病和肝细胞癌，取得了令人鼓舞的结果。本研究的目的是评估使用PTX对代偿期肝硬化患者生存的影响。为此，于1996年6月至2019年12月在瓦伦丁·戈麦斯·法里亚斯博士医院（墨西哥萨波潘国家工人安全和社会服务研究所）的胃肠病学和丙型肝炎科进行了一项横断面研究。这些患者的随访时间为22.6年（至研究期结束）。在本研究中分析了326份患者档案，确定了118例患有该疾病的患者，其中81例（68.64%）在诊断后12年内死亡。纳入的患者中，26例接受了PTX联合聚乙二醇干扰素-α-2a加利巴韦林治疗，11例接受了PTX加普萘洛尔治疗，中位治疗持续时间为20.6±0.8年。此外，16例患者（43%）在此期间未出现合并症，向失代偿期肝硬化的转变时间为16.6年，生存时间为20年。因此，本研究结果表明，PTX可能会改善代偿期肝硬化患者的长期生存，使PTX成为肝硬化治疗中重新利用的候选药物。
