Viral Hepatitis
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 14, 2006; 12(42): 6786-6791
Published online Nov 14, 2006. doi: 10.3748/wjg.v12.i42.6786
Interferon augments the anti-fibrotic activity of an angiotensin-converting enzyme inhibitor in patients with refractory chronic hepatitis C
Hitoshi Yoshiji, Ryuichi Noguchi, Hideyuki Kojima, Yasuhide Ikenaka, Mitsuteru Kitade, Kosuke Kaji, Masahito Uemura, Junichi Yamao, Masao Fujimoto, Masaharu Yamazaki, Masahisa Toyohara, Akira Mitoro, Hiroshi Fukui
Hitoshi Yoshiji, Ryuichi Noguchi, Hideyuki Kojima, Yasuhide Ikenaka, Mitsuteru Kitade, Kosuke Kaji, Masahito Uemura, Junichi Yamao, Masao Fujimoto, Masaharu Yamazaki, Masahisa Toyohara, Akira Mitoro, Hiroshi Fukui, Third Department of Internal Medicine, Nara Medical University, Nara, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hitoshi Yoshiji, MD, PhD, Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan. yoshijih@naramed-u.ac.jp
Telephone: +81-744-223051-2314 Fax: +81-744-247122
Received: July 18, 2006
Revised: September 15, 2006
Accepted: September 22, 2006
Published online: November 14, 2006
Abstract

AIM: To evaluate the effect of combination treatment with the interferon (IFN) and angiotensin-converting enzyme inhibitor (ACE-I) on several fibrotic indices in patients with refractory chronic hepatitis C (CHC).

METHODS: Perindopril (an ACE-I; 4 mg/d) and/or natural IFN (3 MU/L; 3 times a week) were administered for 12 mo to refractory CHC patients, and several indices of serum fibrosis markers were analyzed.

RESULTS: ACE-Idecreased the serum fibrosis markers, whereas single treatment with IFN did not exert these inhibitory effects. However, IFN significantly augmented the effects of ACE-I, and the combination treatment exerted the most potent inhibitory effects. The serum levels of alanine transaminase and HCV-RNA were not significantly different between the groups, whereas the plasma level of transforming growth factor-β was significantly attenuated almost in parallel with suppression of the serum fibrosis markers.

CONCLUSION: The combination therapy of an ACE-Iand IFN may have a diverse effect on disease progression in patients with CHC refractory to IFN therapy through its anti-fibrotic effect.

Keywords: Interferon; Angiotensin-converting enzyme inhibitor; Liver fibrosis; Chronic hepatitis C; Transforming growth factor-β