维生素 D 和替米沙坦联合疗法可抑制肝纤维化的进展

Fatma Amer, Mahmoud El-rehany, Othman Othman
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摘要

肝纤维化是与各种慢性肝损伤相关的一种不正常的伤口修复反应。肝纤维化可通过弥漫性 ECM(细胞外基质)过度沉积和结缔组织异常增生而发现,并可发展为肝硬化或肝细胞癌。包括肝纤维化在内的慢性肝病已在全球范围内造成了严重的发病率和死亡率,而且这种趋势很可能会继续下去。虽然有报道称早期肝纤维化是可以逆转的,但逆转的确切机制尚不明确,而且肝纤维化也缺乏有效的治疗方法。维生素 D 是维持骨骼代谢和钙平衡所必需的。意外的是,新证据表明维生素 D 对肝纤维化具有保护作用。在各种病理情况下,替米沙坦对肝纤维化标志物有积极影响。本综述重点总结了维生素D和替米沙坦对肝纤维化进展的影响,并更新了它们目前对肝纤维化的影响。替米沙坦和维生素D通过抑制嗜碱性基因的产生来减轻肝星状细胞的纤维化。
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Combination Therapy with Vitamin D and Telmisartan to Suppress the Progression of Liver Fibrosis.
Hepatic fibrosis is an improper wound repair response associated with various kinds of chronic liver injuries. It can be detected by over-deposition of diffuse ECM (Extracellular Matrix) and abnormal overgrowth of connective tissue, and it can progress to cirrhosis or hepatocellular carcinoma. Chronic liver diseases, which include liver fibrosis, have resulted in significant morbidity and mortality worldwide, and this trend is likely to continue. Although early liver fibrosis has been reported to be reversible, the exact mechanism of reversal is unidentified, and there is a lack of effective therapy for liver fibrosis. Vitamin D is essential for maintaining the metabolism of bone and calcium balance. Unexpectedly new evidence indicates that vitamin D has a protective function toward hepatic fibrosis. Telmisartan has been shown to have a positive effect on hepatic fibrosis markers in various pathological contexts. This review focused on summarizing the effect of vitamin D and telmisartan on the progression of hepatic fibrosis and updating their present impact on fibrosis. Telmisartan and vitamin D reduce fibrosis in hepatic stellate cells by inhibiting the production of profibrogenic genes.
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