Treatment of nonalcoholic steatohepatitis with vitamins E and C: a pilot study.
Treatment of nonalcoholic steatohepatitis with vitamins E and C: a pilot study.
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DOI：
10.2147/hmer.s41258
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Yamada G
中科院分区：
文献类型：
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作者：
Kawanaka M;Nishino K;Nakamura J;Suehiro M;Goto D;Urata N;Oka T;Kawamoto H;Nakamura H;Yodoi J;Hino K;Yamada G
非酒精性脂肪性肝炎（NASH）是一种常见的肝脏疾病，可进展为肝硬化。氧化应激是导致该病肝细胞损伤的核心机制之一。在这项研究中，对 NASH 患者进行了使用维生素 C 和 E 的抗氧化治疗。 23 名 NASH 患者口服维生素 E 300 mg/天和维生素 C 300 mg/天，为期 12 个月。在治疗期间测量体重指数。在治疗前和 12 个月后，测量所有患者的丙氨酸氨基转移酶、硫氧还蛋白（一种氧化应激标记物）和高敏 C 反应蛋白的血清水平。 23 名患者中有 10 名在治疗前后接受了肝活检。维生素C和E治疗期间体重指数保持不变。与治疗前相比，12个月时血清丙氨酸氨基转移酶、硫氧还蛋白和高敏C反应蛋白水平显着降低。肝活检显示 8 例坏死性炎症活动得到改善，4 例纤维化分期得到改善。维生素 C 和 E 治疗后，血清丙氨酸氨基转移酶、硫氧还蛋白和高敏 C 反应蛋白水平以及肝脏组织学明显改善。这些发现表明，使用这些维生素的联合疗法可能对 NASH 患者有用，可以最大限度地减少氧化应激造成的损害并减缓导致肝硬化的过程。
Nonalcoholic steatohepatitis (NASH) is a common liver disease that can progress to cirrhosis. Oxidative stress is one of the central mechanisms causing hepatocellular injury in the disease. In this study, antioxidant therapy using both vitamins C and E was conducted in patients with NASH. Vitamin E 300 mg/day and vitamin C 300 mg/day were administered orally to 23 patients with NASH for 12 months. Body mass index was measured during therapy. Serum levels of alanine aminotransferase, thioredoxin (an oxidative stress marker), and high-sensitivity C-reactive protein were measured before treatment and after 12 months in all patients. Ten of the 23 patients underwent liver biopsy before and after treatment. Body mass index remained unchanged during treatment with vitamins C and E. Serum alanine aminotransferase, thioredoxin, and high-sensitivity C-reactive protein levels were decreased significantly at 12 months compared with pretreatment. Liver biopsies showed improved necroinflammatory activity in eight cases and improved fibrosis staging in 4. Serum alanine aminotransferase, thioredoxin, and high-sensitivity C-reactive protein levels, and liver histology were clearly improved with vitamin C and E therapy. These findings suggest that combination therapy using these vitamins may be useful in patients with NASH to minimize damage from oxidative stress and slow the processes leading to cirrhosis.