Long term effects of phlebotomy on biochemical and histological parameters of chronic hepatitis C

Yano, Motoyoshi; Hayashi, Hisao; Wakusawa, Shinya; Sanae, Fujiko; Takikawa, Toshikuni; Shiono, Yuhta; Arao, Motohiro; Ukai, Katsuyuki; Ito, Hiroshi; Watanabe, Kazumasa; Yoshioka, Kentaro

doi:10.1111/j.1572-0241.2002.05436.x

Cited by 106 publications

(26 citation statements)

References 22 publications

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“…An accelerated evolution to severe fibrosis was also observed in patients with hepatitis C carrying HFE mutation 38 . Reinforcing the harmful role of iron deposits, phlebotomies used as iron reduction therapy have been shown to reduce serum aminotransferase levels, improve liver inflammation and suppress the progression of liver fibrosis in patients with chronic hepatitis C 39 …”

Section: Discussionmentioning

confidence: 94%

Hepatic stellate cells in hepatitis C patients: Relationship with liver iron deposits and severity of liver disease

Martinelli¹,

Ramalho

Zucoloto

2003

J of Gastro and Hepatol

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Section: Discussionmentioning

confidence: 94%

Hepatic stellate cells in hepatitis C patients: Relationship with liver iron deposits and severity of liver disease

Martinelli¹,

Ramalho

Zucoloto

2003

J of Gastro and Hepatol

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“…However, during IFN-based antiviral treatment, weight loss is apparent in 11–29% of patients because of decreased appetite and malnutrition [28–32]. Although reducing iron by phlebotomy and a low iron diet are also effective for liver injury in CHC patients [33–35], some patients still take iron-rich food and supplements because they believe the incorrect information that glycogen- and iron-rich corbiculae, curcuma, and bovine liver, which are traditional food used to treat acute hepatitis in folk remedies, show therapeutic effects for chronic hepatitis. …”

Section: Profile Of Nutritional Intake In Chc Patientsmentioning

confidence: 99%

“…When excessive iron changes to Fe 3+ from Fe 2+ , free radicals are produced and the oxidative stress causes injury of cell-membrane and DNA, leading to hepatitis progression. To prevent the iron-mediated injury, phlebotomy and low iron diet therapy is effective [33–35]. Long-term phlebotomy with low-iron diet therapy lowers the risk of development of hepatocellular carcinoma (HCC) from CHC [60].…”

Section: Nutrition Therapy For Chc Patientsmentioning

confidence: 99%

Nutrition Therapy for Liver Diseases Based on the Status of Nutritional Intake

Yasutake

Kohjima

Nakashima

et al. 2012

Gastroenterology Research and Practice

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The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake; hence, nutritional support is also required during therapy to prevent undernourishment, treatment interruption, and a reduction in quality of life. Moreover, addition of some nutrients that act to suppress viral proliferation is recommended. As a substitutive treatment, low-iron diet therapy, which is relatively safe and effective for preventing hepatocellular carcinoma, is also recommended for CHC patients. Some patients with liver cirrhosis (LC) have decreased dietary energy and protein intake, while the number of LC patients with overeating and obesity is increasing, indicating that the nutritional state of LC patients has a broad spectrum. Therefore, nutrition therapy for LC patients should be planned on an assessment of their complications, nutritional state, and dietary intake. Late evening snacks, branched-chain amino acids, zinc, and probiotics are considered for effective nutritional utilization.

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“…ROS, detected using an electron paramagnetic resonance spin probe, were positively correlated with histological disease activity in chronic hepatitis C patients (74). Iron depletion therapy reduced oxidative damage, improved ALT levels, reduced inflammation and progression of fibrosis, and decreased the risk of HCC among hepatitis C patients (133, 155–157). Conversely, increasing hepatic iron enhanced liver steatosis and HCC formation in transgenic mice expressing HCV polyprotein (47, 158).…”

Section: Oxidative Stress and Pathogenesis Of Hccmentioning

confidence: 99%

Oxidative stress and hepatic Nox proteins in chronic hepatitis C and hepatocellular carcinoma

Choi

Corder-Ramos

Koduru

et al. 2014

Free Radical Biology and Medicine

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Hepatocellular carcinoma (HCC) is the most common liver cancer and a leading cause of cancer-related mortality in the world. Hepatitis C virus (HCV) is a major etiologic agent of HCC. A majority of HCV infections lead to chronic infection that can progress to cirrhosis and eventually, HCC and liver failure. A common pathogenic feature present in HCV infection, and other conditions leading to HCC, is oxidative stress. HCV directly increases superoxide and H2O2 formation in hepatocytes by elevating Nox protein expression and sensitizing mitochondria to reactive oxygen species generation while decreasing glutathione. Nitric oxide synthesis and hepatic iron are also elevated. Furthermore, activation of phagocytic NADPH oxidase 2 (Nox2) of host immune cells is likely to exacerbate oxidative stress in HCV-infected patients. Key mechanisms of HCC include: genome instability, epigenetic regulation, inflammation with chronic tissue injury and sustained cell proliferation, and modulation of cell growth and death. Oxidative stress, or Nox proteins, plays various roles in these mechanisms. Nox proteins also function in hepatic fibrosis, which commonly precedes HCC, and Nox4 elevation by HCV was mediated by transforming growth factor beta. This review summarizes mechanisms of oncogenesis by HCV, highlighting the role of oxidative stress and hepatic Nox enzymes in HCC.

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Long term effects of phlebotomy on biochemical and histological parameters of chronic hepatitis C

Abstract: These results suggest that phlebotomy with maintenance lowers serum aminotransferase levels, improves liver inflammation, and suppresses the progression of liver fibrosis in chronic hepatitis C.

Cited by 106 publications

References 22 publications

Hepatic stellate cells in hepatitis C patients: Relationship with liver iron deposits and severity of liver disease

Hepatic stellate cells in hepatitis C patients: Relationship with liver iron deposits and severity of liver disease

Nutrition Therapy for Liver Diseases Based on the Status of Nutritional Intake

Oxidative stress and hepatic Nox proteins in chronic hepatitis C and hepatocellular carcinoma

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