为含酒精的肝炎的治疗的最近、当前新兴的医疗选择

• 作者: Gabriel L Reep Roger D Soloway
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Alcoholic hepatitis Tumor necrosis factor-α inhibitors INFLIXIMAB ETANERCEPT ANTIOXIDANTS PROBIOTICS RIFAXIMIN BETAINE Granulocytapheresis
• 年，卷（期）: 2011,（8）
• 页码范围: 211-214
• 页数: 4页
• 分类号: R575.1

摘要

Patients with severe alcoholic hepatitis (AH) need to be treated with specific treatment for better outcome.Currently available specific treatment modalities are use of corticosteroids or pentoxifylline.However,the response rate to these drugs is only about 50%-60%.Hence,there is an urgent need for better and more effective treatment options.Tumor necrosis factor plays an important role in the pathogenesis of AH.However,agents blocking the action of tumor necrosis factor have not been found to be effective.Rather the randomized studies evaluating these agents showed an adverse effect and more infections in treated patients.Critical role of tumor necrosis factor in hepatic regen-eration explaining this contrast is discussed.Oxidative stress and inflammation derived from gut bacteria ate two main components in the pathogenesis of AH laying foundation for the role of antioxidants,probiotics,and antibiotics in the management of AH.This article reviews the current data and status of these newer agents for the treatment of AH.Of the various options available,Vitamin E and N-acetylcysteine (NAC) have shown great promise for clinical use as adjunct to corticosteroids.With these encouraging data,future well designed studies are suggested to assess Vitamin E and NAC before their routine use in clinical practice in the management of AH.