Journal
ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH
Volume 35, Issue 11, Pages 1960-1965Publisher
WILEY
DOI: 10.1111/j.1530-0277.2011.01547.x
Keywords
S-Adenosylmethionine; S-Adenosyl-L-Methionine; Alcoholic Liver Disease
Categories
Funding
- National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) [R01AA14562, R01AG09834, P50 011999, R01DK072398, UL1 RR024146]
- NIH Roadmap for Medical Research
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Background: S-adenosyl-L-methionine (SAM) is the methyl donor for all methylation reactions and regulates the synthesis of glutathione, the main cellular antioxidant. Previous experimental studies suggested that SAM may benefit patients with established alcoholic liver diseases (ALDs). The aim of this study was to determine the efficacy of SAM in treatment for ALD in a 24-week trial. The primary endpoints were changes in serum aminotransferase levels and liver histopathology scores, and the secondary endpoints were changes in serum levels of methionine metabolites. Methods: We randomized 37 patients with ALD to receive 1.2 g of SAM by mouth or placebo daily. Subjects were required to remain abstinent from alcohol drinking. A baseline liver biopsy was performed in 24 subjects, and a posttreatment liver biopsy was performed in 14 subjects. Results: Fasting serum SAM levels were increased over timed intervals in the SAM treatment group. The entire cohort showed an overall improvement of AST, ALT, and bilirubin levels after 24 weeks of treatment, but there were no differences between the treatment groups in any clinical or biochemical parameters nor any intra-or intergroup differences or changes in liver histopathology scores for steatosis, inflammation, fibrosis, and Mallory-Denk hyaline bodies. Conclusions: Whereas abstinence improved liver function, 24 weeks of therapy with SAM was no more effective than placebo in the treatment for ALD.
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