期刊
LIVER INTERNATIONAL
卷 29, 期 8, 页码 1184-1188出版社
WILEY
DOI: 10.1111/j.1478-3231.2009.02037.x
关键词
adiponectin; apoptosis; NASH; ursodeoxycholic acid; vitamin E
资金
- ELISA
- Stiftung fur die Leberkranheiten
Background/Aims Adipokines and hepatocellular apoptosis participate in the pathogenesis of nonalcoholic steatohepatitis (NASH). In a randomized trial ursodeoxycholic acid (UDCA) with vitamin E (VitE) improved serum aminotransferases and hepatic histology. The present work evaluates the effect of this combination on adipokines and hepatocellular apoptosis. Methods Circulating levels of adiponectin, resistin, leptin, interleukin (IL)-6, IL-8, retinol binding protein-4, monocyte chemoattractant protein-1 and tumour necrosis factor-alpha were measured by enzyme-linked immunoassays at the beginning and after 2 years of treatment with either UDCA+VitE, UDCA+placebo (P) or P+P. Apoptosis was assessed by immunohistochemistry for activated caspase-3 and circulating levels of apoptosis-associated cytokeratin 18 fragments (M30). Results Levels of adiponectin increased in patients treated with UDCA+VitE, whereas they decreased in the two other groups (P < 0.04) and correlated with the improvement of liver steatosis (P < 0.04). M30 levels worsened in the P/P group and improved in the other two groups. They correlated with hepatocellular apoptosis (P < 0.02) and steatosis (P < 0.02) as well as negatively with adiponectin levels (P < 0.04). Conclusions UDCA+VitE improves not only aminotransferase levels and liver histology of patients with NASH, but also decreases hepatocellular apoptosis and restores circulating levels of adiponectin. These results suggest that the UDCA+VitE combination has metabolic effects in addition to its beneficial cytoprotective properties.
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