A cirrhosis prevenciója - A májfibrosis diagnosztikája és a kezelés lehetoségei

Translated title of the contribution: Diagnosis and treatment of liver fibrosis - As the prevention of cirrhosis

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Abstract

Liver fibrosis is consequence of most chronic liver diseases. Early recognition and inhibition of fibrosis can be regarded as a tool for the prevention of cirrhosis. In this paper we review diagnostic procedures and treatment modalities of fibrogenesis as well as present our experiences. Liver biopsy is cosidered as gold standard to assess the severity of necroinflammation and fibrosis, and to guide therapy. However, it is an invasive procedure, associated with potential risk of morbidity and mortality and has limitations including sampling error. Thus there is a need for non-invasive methods to study of fibrosis and to monitor disease progression. Imaging techniques such as ultrasound, Doppler, MRI and recently transient elastography have been proposed as potential alternatives to repeated biopsies. Two groups of serological markers of fibrosis are discussed, the indirect ones, the routin hematological and biochemical parameters and the direct fibrosis markers (extracellular matrix components or enzymes directly involved in fibrogenesis), which can be applied for identifying or exclusive severe fibrosis. Using these variables, different algorhythms, combination panels have also been generated. Authors studied plasma levels of transforming growth factor (TGF-β), hyaluronic acid (HA) and procollagen-III-peptide (P-III-P) in different forms of chronic hepatitis C virus (HCV) infection, in patients with active hepatitis C, symptomfree HCV-carriers with persistently normal alanine aminotransferase and who previously achieved sustained virological response. In addition, the effect of interferon plus ribavirin therapy on these parameters have also been followed-up. While TGF-b levels correlated with the histological activity, HA levels significantly decreased during antiviral therapy, independently of virological response. Low values occured in symptomfree HCV carriers and also in those with sustained remission. The second part of the paper deals with the problems of antifibrotic treatment. Although the best strategy to prevent cirrhosis is the elimination of the primary cause of parenchymal damage, utilization antifibrotic agents and/or antioxidants can also be of importance in supporting the etiological (antiviral) or rational (immunmodulatory) theraphy. A list of these potentially promising modalities is given. Long-term controlled clinical of theoretically effective antifibrotic pharmacons.

Translated title of the contributionDiagnosis and treatment of liver fibrosis - As the prevention of cirrhosis
Original languageHungarian
Pages (from-to)1600-1610
Number of pages11
JournalOrvosi hetilap
Volume147
Issue number33 SUPPL. 1
Publication statusPublished - Aug 20 2006

ASJC Scopus subject areas

  • Medicine(all)

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