Unfortunately, initial trials of insulin-sensitizing agents such as metformin and pioglitazone have not shown significant improvements in HCV treatment outcome in patients receiving peginterferon/ribavirin.[Romero-Gómez 2009; Harrison 2012] Weight loss can improve insulin sensitivity and therefore should be encouraged in overweight patients before starting therapy.
Here is a link to an excellent presentation by Dr. Jean-Michel Pawlotsky.
Study Confirms Benefits of Vitamin E in Nonalcoholic Steatohepatitis
Megan Brooks
May 4, 2010 — Supplementation with the natural form of vitamin E (800 IU/day) has beneficial effects in patients with nonalcoholic steatohepatitis (NASH), but pioglitazone's benefits are less clear, according to the latest findings from the Pioglitazone vs Vitamin E vs Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis (PIVENS) trial, reported online April 28 in the New England
To test the effectiveness of pioglitazone and vitamin E, Sanyal and colleagues at 11 other medical facilities identified 247 people who had severe fatty liver disease. None of the volunteers drank alcohol excessively or was diabetic, but all were overweight or obese. Their average age was in the mid-40s.
The researchers randomly assigned participants to one of three treatments — vitamin E, pioglitazone or a placebo capsule — taken daily for nearly two years.
We also found that P. amarus suppressed HBsAg gene expression at mRNA level in a time-dependent manner, and selectively abolished the HBsAg gene promoter driven CAT activity. Our results demonstrate that P. amarus contains some active components which can suppress the HBsAg gene expression in human hepatoma cells. Such suppression may contribute the antiviral activity of P. amarus in vivo.
Several mechanisms including (i) immunomodulatory properties, (ii) inhibition of the inosine monophosphate dehydrogenase, (iii) direct inhibition of the HCV-encoded NS5B RNA polymerase, (iv) induction of lethal mutagenesis and (v) modulation of interferon-stimulated gene expression are currently proposed. Here, we discuss recent advances from in vitro data and their importance for the situation in patients with chronic hepatitis C.
Nowadays doctors are stopping to use metformin kindly read and do some r&d. Initially even i was on Metformin for PCOD and my doctor suggested to stop it.
Incubation of human proximal tubular cells with MPA increased NEP gene expression in a dose- and time-dependent manner. Moreover, MPA reduced angiotensin II-induced expression of the profibrotic factor plasminogen activator inhibitor-1, and a specific NEP inhibitor completely reversed this effect. Taken together, our data suggest that MPA directly induces expression of neutral endopeptidase, which may reduce proteinuria and slow the progression of renal damage in kidney transplant recipients.
These findings suggest that chronic administration of TZD has anticancer activity in the liver via inhibition of NPM expression and indicate that these drugs might be useful for HCC chemoprevention and treatment. HEPATOLOGY 2010.
http://en.wikipedia.org/wiki/Thiazolidinedione
this drug is same family as Rosiglitazone (Avandia) which has been foud active on hbsag and hbvdna, question is does TZD lower hbsag since decrease of hbsag inibits cancer growth too and if lowered to und eradicate hbv?
At 2 to 12 h post-dose, all animals with undetectable serum IFN-α had concurrent two-fold or higher elevation of the hepatic expression of OAS1, MX1, or ISG15 (Figure 1). At 24 h, the hepatic anti-viral gene expression was comparable to vehicle-treated and naïve control animals (not shown).
Conclusions: Low dose (0.3 mg/kg) treatment of mice with GS-9620 induced hepatic expression of MX1, OAS1, and ISG15 in animals with undetectable IFN-α in serum.
This was accompanied by a significant increase, compared to BDL alone, in αSMA gene and protein expression, as well as elevated bilirubin, ALT, ALP and GGT levels and increased oxidative stress (p<0.05). BDL resulted in elevated hepatic RAGE gene expression, with a further significant increase with AGE infusion.
Summary/Conclusions: In normal liver, AGE exposure does not cause significant liver injury.
Nonalcoholic steatohepatitis (NASH) is a hepatic disorder associated with the metabolic syndrome and insulin resistance. It is a very common problem for which no therapy, short of diet/weight loss and exercise, has shown benefit. Extreme measures of weight loss include bariatric surgery, which has not been well studied, but may be beneficial.[1] Accordingly, there is considerable interest in developing pharmacologic therapies directed toward addressing the presence of insulin resistance.
Thank You very much for your reply,
As I mentioned above, she was given new medicined once she experienced high blood sugar level few weeks back. She was given Metformin (850 mg) and Pioglitazone (30Mg per day). Once she started experiencing low blood sugar level, the doctor stopped giving Pioglitazone and asked to continue Metformin with few other medicines and the my mother was told that she experiencing such low levels of sugar due to Pioglitazone.
I am on hydrochlorothiazide (water pill) and Zocor for high cholestoral. Also take Humalog and Lantas insulin (4 shots per day). Take Prilosec for GERD and a potasium pill. Also on Peri-Colace for stomach problems. Spoke with the Dr. and discontinued all pills for a few days to see if it had any effect and it did not. Still swelling. Right now about 5 pounds of water, by tonight it will be 10 pounds.
In the first study, the investigators found that curcumin promotes peroxisome proliferator-activated receptor-gamma (PPAR-gamma) gene expression and suppresses expression of the low-density lipoprotein (LDL) cholesterol receptor gene, which in turn lowers the level of intracellular cholesterol and thereby reduces the stimulatory effect of LDL on hepatic stellate cell activation.
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