E vitamīns uzlabo aknu darbību
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24.02.2020
Nealkoholiskais steatohepatīts ir nealkoholisko taukaino aknu smaga slimības forma, kam raksturīgi aknu šūnu (hepatocītu) bojājumi. Šī potenciāli bīstamā slimība var progresēt līdz cirozei vai aknu vēzim.
Pastāv vairākas teorijas, kas izskaidro, kāpēc ir tik augsts nealkoholisko taukaino aknu slimības izplatības līmenis starp HIV pozitīvajiem pacientiem.
Iespējams, tas saistīts ar hronisku iekaisumu, kas saistīts ar HIV, vai ar antiretrovīrusu preparātiem, kurus viņiem jālieto visas dzīves garumā, vai ar ļoti biežām metaboliskām problēmām, piemēram, diabētu un augstu lipīdu līmeni. Diemžēl pagaidām nav akceptētas terapijas, lai ārstētu taukaino aknu slimību cilvēkiem, kas dzīvo ar HIV.
Neliela pētījuma laikā 27 pacienti ar HIV un nealkoholisko taukaino hepatozi 24 nedēļas perorāli saņēma E vitamīnu (alfa-tokoferolu), kura dienas deva bija 800 SV, bet pēc tam pacienti tika novēroti vēl 24 nedēļas. Nekādas nopietnas blakusparādības netika novērotas.
Tika noskaidrots, ka E vitamīns uzlabo aknu transamināzes (ALAT, ASAT) un samazina tauku līmeni aknās, ko nosaka, izmantojot neinvazīvos ultraskaņas testus (fibroskānu).
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Source: AIDS | «Vitamin E is an effective treatment for nonalcoholic steatohepatitis in HIV mono-infected patients» | https://insights.ovid.com/crossref?an=00002030-202002010-00009 |
<... Abstract
Objective:
HIV-infected patients are at increased risk of nonalcoholic steatohepatitis (NASH). Vitamin E is recommended for treatment of NASH in the general population. However, its safety and efficacy among HIV-infected patients remain unknown.
Design:
Single-centre, phase IV, open-label, single arm clinical trial.
Methods:
HIV mono-infected patients without significant alcohol intake or viral hepatitis coinfection were included. The diagnosis of NASH was based on the co-existence of fatty liver, diagnosed by controlled attenuation parameter (CAP) at least 248 dB/m and significant hepatocyte apoptosis, defined by the serum biomarker cytokeratin 18 (CK-18) greater than 130.5 U/L. Participants were treated with 800 IU daily of oral vitamin E (alpha-tocopherol) for 24 weeks, and followed for an additional 24 weeks postdiscontinuation. Generalized linear mixed effects models were used to evaluate changes in alanine aminotransferase (ALT), CAP and CK-18 at the completion of treatment and end of follow-up, controlling for pretreatment trends.
Results:
A total of 27 patients were included. Four (15%) had a pretreatment liver biopsy, which confirmed the diagnosis of NASH in all cases. Compared with baseline, 24 weeks of vitamin E treatment improved ALT [−27 units/l; 95% confidence interval (CI) −37 to −17], CAP scores (−22 dB/m; 95% CI −42 to −1) and CK-18 (−123 units/l; 95% CI −201 to −46). Conversely, there was no change in BMI. No serious adverse event was reported and no patient was lost to follow-up.
Conclusion:
In this first clinical trial, we showed that vitamin E is an effective and well tolerated treatment for NASH in HIV-infected patients. ...>
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