Klin Farmakol Farm. 2006;20(3):154-157

HEPATOPROTECTIVES

doc. MUDr. Radan Brůha CSc
IV. interní klinika VFN a 1. LF UK, Praha

Hepatoprotectives are substances with potential positive effect on liver cell regeneration or to slowering of pathological processes in chronic liver diseases. These effects were confirmed in experimental studies with many substances; nevertheless the clinical use is limited.

Ursodeoxycholic acid possess the positive effect in patients with primary biliary cirrhosis or other cholestatic diseases. This is a treatment of choice in this indication. Similar effect can be attributed to S-adenosyl methionine.

Recently many herbal extracts are very popular. In practical use is silymarine, which can slow down the fibrotic process by antioxidant characteristcs.

Another substance is essentiale phospholipid, which can accelerate the reparation of cell membranes.

On conclusion, randomized controlled studies confirmed the efficacy of ursodeoxycholic acid. Other medicaments are used based on controversial results of small or uncontrolled studies and based on local and personal experiences.

Keywords: Key words: hepatoprotectives, fibrotisation, liver cirrhosis, liver damage.

Published: January 1, 2007  Show citation

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Brůha R. HEPATOPROTECTIVES. Klin Farmakol Farm. 2006;20(3):154-157.
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    References

    1. Goulis J, Leandro G, Burroughs AK. Randomized controlled trials of ursodeoxycholic acid therapy for primary biliary cirrhosis: a meta-analysis. Lancet 1999;354:1653. Go to original source... Go to PubMed...
    2. Pares A, Caballeria I, Rodes J et al. Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. J Hepatol 2000;32:561. Go to original source... Go to PubMed...
    3. Meng L-J, Reyes H, Axelson M et al. Progesterone metabolites and bile acid in serum of patients with intrahepatic cholestasis of pregnancy: effect of ursodeoxycholic acid thrapy. Hepatology 1997;26:1573. Go to original source... Go to PubMed...
    4. Lieber CS. Alcohol and the liver: 1994 update. Gastroenterology 1994;106:1085. Go to original source... Go to PubMed...
    5. Roy CK, Kamath JV, Asad M. Hepatoprotective activity of Psidium guajava Linn. leaf extract. Indian J Exp Biol 2006;44:305-311.
    6. Galati FM, Mondello MR, Lauriano ER, Taviano MF, Galluzzo M, Miceli N. Opuntia ficus indica (L.) Mill. fruit juice protects liver from carbon tetrachloride-induced injury. Phytother Res 2005;19:796-800. Go to original source... Go to PubMed...
    7. Kalab M, Krechler T. The effect of the hepatoprotective agent Liv-52 on liver damage. Cas Lek Ces 1997;136:758-760.
    8. De Silva HA, Saparamadu PA, Thabrew MI, Pathmeswaran A, Fonseka MM, De Silva HJ. Liv 52 in alcoholic liver disease: a prospective, controlled trial. J Ethnopharmacol 2003;84:47-50. Go to original source... Go to PubMed...
    9. Pietrangelo A, Borrella F, Casalgruadi G et al. Antioxidant activity of silybin in vivo during long term iron overload in rats. Gastroenterology 1995;109:1941-1949. Go to original source... Go to PubMed...
    10. Tuchweber B, Sieck R, Ttrost W. Prevention of silybin of phalloidin induced acute hepatotoxicity. Toxicol Appl Pharmacol 1979;51;265-275. Go to original source... Go to PubMed...
    11. Faulstich H, Jahn W, Wieland T. Silybin inhibition of amatoxin uptake in the perfused rat liver. Arzeinmittelforschung 1980;30:452-454.
    12. Ferenci P, Dragosics B, Dittrich H, Frank H, Benda L, Lochs H, Meryn S, Base W, Schneider B. Randomized controlled trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol 1989;9:105-113. Go to original source... Go to PubMed...
    13. Jacobs BP, Dennehy C, Ramirej G, Sapp J, Lawrence VA. Milk thistle for the treatment of liver diseases: a systematic review and metaanalysis. Am J Med 2002;113:506-515. Go to original source... Go to PubMed...
    14. Maiwald L. "Essential" Phospholipids in Liver Disease. Fortschr Med 1986;104 (14):299-302. Go to PubMed...
    15. Sherlock S, Dooley J. Diseases of the Liver and Biliary System. Ninth edition, Blackwell Scientific Publications, Oxford 1993.
    16. Le Kim VD, Graf E. Tierexperimentelle Studie zur Pharmakokinetik der Essentialen Phospholipide (EPL). Drug Research 1976;26:1772-1982.
    17. Lieber CS, De Carli LM, Mak KM, Kim CI, Leo MA. Attenuation of Alcohol-induced Hepatic Fibrosis by Polyunsaturated phosphatidylcholine. Hepatology 1990;12:1390-1398. Go to original source... Go to PubMed...
    18. Katuscak I, Hendrich F, Vladar L, Valentik M, Horakova M, Lauko L. Essential Phospholipids in the Treatment of Alcohol-induced Steatosis and Hepatitis. Cas Lek Ces 1988;127(18):556-559.
    19. Holoman J, Glasa J, Hlavaty I, Veningerova M, Prachar V, Lukacsova M. Positive effects of essential phospholipids and improvement of life style in patients with toxic liver injury. Bratisl Lek Listy 1998;99:75-81. Go to PubMed...
    20. Jenkins PJ, Portmann BP, Edpodleston ALWF, Wiliams R. Use of Polyunsaturated Phosphatidylcholine in HBsAg Negative Chronic Hepatitis: Resuls of a Prospective Double-blind Controlled Trial. Liver 1982;2:77-81. Go to original source... Go to PubMed...
    21. Hantak I, Boca M, Mikulecky M, Stancek D. Essential Phospholipids in the Treatment of Chronic Hepatitis B Virus Infection. Vnitr Lek 1990;36:1164-1171. Go to PubMed...
    22. Visco G. Polyunsaturated Phosphatidylcholine in Association with Vitamin B Complex in the Treatment of Acute Viral Hepatitis B. Results of a Randomized Double-blind Clinical Study. Clin Ter 1985;114:183-188. Go to PubMed...
    23. Ilic V. Efficacy of "Essential" Phospholipids in the Treatment of Acute and Chronic Disease. Z Gastroenterol (Suppl.2) 1991;29:25-29.
    24. Kalab M, Cervinka J. Essential Phospholipids in the Treatment of Liver Cirrhosis. Cas Lek Ces 1983;122(9):266-269.
    25. Brůha R, Mareček Z. Esenciální fosfolipidy v léčbě jaterní encefalopatie. Vnitr Lek 2000;46(4):199-204. Go to PubMed...
    26. Lata J, Dastych M Jr, Senkyrik M, Husova M, Stary K. Protektivní vliv esenciálních fosfolipidů na jaterní poškození při parenterální výživě. Vnitr Lek 2001;47:599-603. Go to PubMed...
    27. Nakamura T, Sakata R, Ueno T, Sata M, Ueno H. Inhibition of transforming growth factor beta prevents progression of liver fibrosis and enhace hepatocyte regeneration in dimethylnitrosamine-treated rats. Hepatology 2000;32:247-255. Go to original source... Go to PubMed...
    28. Croquet V, Moal F, Veal N et al. Hemodynamic and antifibrotic effects of losartan in rats with liver fibrosis and/or portal hypertension. J Hepatol 2002;37:773-780. Go to original source... Go to PubMed...
    29. Teoh N, Field J, Farrell G. Interleukin-6 is a key mediator of the hepatoprotective and pro-proliferative effects of ischaemic preconditioning in mice. J Hepatol 2006; in press. Go to original source... Go to PubMed...

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