Cytokines and NASH: A pilot study of the effects of lifestyle modification and vitamin E
Cytokines and NASH: A pilot study of the effects of lifestyle modification and vitamin E
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DOI：
10.1053/jhep.2003.50316
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发表时间：
2003-08-01
期刊：
影响因子：
13.5
通讯作者：
McClain, CJ
中科院分区：
文献类型：
--
作者：
Kugelmas, M;Hill, DB;McClain, CJ
很少有数据评价血浆和/或外周血单核细胞细胞因子浓度/产生或试图操纵非酒精性脂肪性肝炎（NASH）中的促炎细胞因子。一个综合临床研究中心的试点项目评估了第1步美国心脏协会饮食加有氧运动加或不加每天800 IU维生素E对16名活检证实的NASH患者细胞因子谱和肝酶水平的影响。肝功能、血脂和体重指数的生化评估在治疗的前6周内显著改善，并在随后的6周内保持稳定。血浆透明质酸（HA）浓度与体重减轻平行下降。NASH患者血浆肿瘤坏死因子（TNF）浓度显著升高，与稳定性酒精性肝硬化患者相似，但不像急性酒精性脂肪性肝炎（AH）患者那样升高。虽然血浆TNF、白细胞介素8（IL-8）和IL-6浓度与对照值相比均显著升高，但只有血浆IL-6水平在治疗后显著降低。NASH患者外周血单核细胞TNF、IL-8和IL-6的产生显著升高，但没有显著降低。在这个小样本中没有观察到维生素E的独立作用。总之，NASH患者的细胞因子代谢失调与AH中记录的异常相似，但不太明显。在研究期间，无论有无维生素E，细胞因子值通常不会随着体重减轻而显著降低。生活方式的改变（低脂饮食和运动）与NASH患者的肝酶、胆固醇和血浆HA水平的改善相关，而在这项短期初步研究中使用的维生素E补充水平没有提供明显的额外益处。
There are few data evaluating plasma and/or peripheral blood monocyte cytokine concentrations/production or attempts to manipulate proinflammatory cytokines in nonalcoholic steatohepatitis (NASH). A pilot project in a general clinical research center evaluated the effects of a step 1 American Heart Association diet plus aerobic exercise with or without 800 IU of vitamin E daily on cytokine profiles and liver enzyme levels in 16 patients with biopsy-proven NASH. Biochemical assessment of liver function, lipid profiles, and body mass index significantly improved during the first 6 weeks of therapy and remained stable during the following 6 weeks. Plasma hyaluronic acid (HA) concentrations decreased in parallel with weight loss. Plasma tumor necrosis factor (TNF) concentrations were significantly elevated in patients with NASH and similar to patients with stable alcoholic cirrhosis but not as elevated as in patients with acute alcoholic steatohepatitis (AH). Although plasma TNF, interleukin 8 (IL-8), and IL-6 concentrations were all significantly elevated compared with control values, only plasma IL-6 levels significantly decreased with therapy. Peripheral blood monocyte TNF, IL-8, and IL-6 production was significantly elevated in patients with NASH but did not significantly decrease. Independent effects of vitamin E were not observed in this small sample. In conclusion, patients with NASH have dysregulated cytokine metabolism similar to, but less pronounced than abnormalities documented in AH. Cytokine values generally did not decrease significantly with weight loss with or without vitamin E over the duration of the study. Lifestyle modifications (low-fat diet and exercise) were associated with improvement in liver enzymes, cholesterol, and plasma HA levels in patients with NASH, whereas the level of vitamin E supplementation used in this short-term pilot study provided no apparent added benefit.