H Hayashi1, T Takikawa, N Nishimura, M Yano. 1. Research Laboratory for Development of Medicine, Faculty of Pharmaceutical Sciences, Hokuriku University, Kanazawa, Japan.
Abstract
BACKGROUND/AIMS: Iron cytotoxicity may play an important role in chronic hepatitis C. The effects of venesection suggest that a slight iron overload contributes to hepatic injury in subjects infected with hepatitis C virus. A better indication of the efficacy of venesection was studied in patients with and without overt iron overloading. METHODS: All 40 patients had chronic hepatitis C but none had hemochromatosis of a known etiology. A serum ferritin level of 10 ng/ml or less was chosen as the treatment goal. A mean blood volume of 2400 +/- 1100 ml was removed during treatments lasting 5 +/- 3 months. RESULTS: Treatment significantly reduced the mean serum levels of alanine aminotransferase activity from 128 +/- 74 to 63 +/- 28 IU/l (p < 0.01). The baseline enzyme activity was highly correlated with reduction in activity after treatment (r = 0.94, p < 0.01), but the baseline levels of ferritin and histochemistry for iron showed poor correlations with the reduction in enzyme activity (r = 0.63 with p < 0.01 and r = 0.38 with p < 0.05, respectively). CONCLUSIONS: Thus, serum levels of aminotransferases were a more important indicator for venesection than conventional indices of iron overload, probably because cytotoxic iron includes some reactive iron species rather than stored iron alone.
BACKGROUND/AIMS: Ironcytotoxicity may play an important role in chronic hepatitis C. The effects of venesection suggest that a slight iron overload contributes to hepatic injury in subjects infected with hepatitis C virus. A better indication of the efficacy of venesection was studied in patients with and without overt iron overloading. METHODS: All 40 patients had chronic hepatitis C but none had hemochromatosis of a known etiology. A serum ferritin level of 10 ng/ml or less was chosen as the treatment goal. A mean blood volume of 2400 +/- 1100 ml was removed during treatments lasting 5 +/- 3 months. RESULTS: Treatment significantly reduced the mean serum levels of alanine aminotransferase activity from 128 +/- 74 to 63 +/- 28 IU/l (p < 0.01). The baseline enzyme activity was highly correlated with reduction in activity after treatment (r = 0.94, p < 0.01), but the baseline levels of ferritin and histochemistry for iron showed poor correlations with the reduction in enzyme activity (r = 0.63 with p < 0.01 and r = 0.38 with p < 0.05, respectively). CONCLUSIONS: Thus, serum levels of aminotransferases were a more important indicator for venesection than conventional indices of iron overload, probably because cytotoxic iron includes some reactive iron species rather than stored iron alone.
Authors: Massimo Franchini; Giovanni Targher; Franco Capra; Martina Montagnana; Giuseppe Lippi Journal: Hepatol Int Date: 2008-05-08 Impact factor: 6.047