Cirrhosis is a chronic lesion with the accumulation of scar tissue and that alters the structure and function of the liver. Once a patient is cured of Hepatitis C, the danger is not over if the liver is heavily scarred. Currently there is no cure or reversal agent for cirrhosis short of a transplant.
As cirrhosis progresses, the liver tries to heal itself but the cycle builds scar tissue upon scar tissue and blood cannot flow through the liver. This causes a backup of blood which causes portal hypertension (high blood pressure of the liver). This is incompatible with life. When the liver cannot filter blood, the body compensates by growing vessels around the liver to move blood. And life threatening consequences occur. Frequent results are the pathological creation of blood vessels, ruptured veins in the stomach and esophagus, the inability to stop bleeding, liver cancer, therefore death.
In the past, treatments have targeted blood vessel growth to prevent new weak blood vessels that burst under pressure.
- Drugs that stop blood vessel growth, do the same thing in the brain and throughout the body so the blocking of VEGF (vascular endothelial growth factor) receptors is damaging to normal blood vessel growth.
- Most therapies are delivered by blood, but since the liver is scarred, the drugs bypass the liver and sight of inflammation and scar tissue.
Sounds complicated doesn’t it? Well if you have received treatment for Hepatitis C, you already have a working knowledge of the liver.
Scientists say as the liver attempts to repair itself, the new nodules have high levels of CPEB4 protein and these new nodules form liver cancer cells. CBEP4 has been linked to blood vessel growth in brain and pancreatic cancers. By blocking CBEP4, normal vascular cells grow but the damaged nodules don’t. These experiments have been performed in cells in vitro, animals, and in sample tissue from patients with cirrhosis.
The researchers are working on the role of blocking proteins, and possible treatments for liver carcinomas. Currently liver carcinomas are the main liver cancer and the third deadliest cancer world-wide, with a 5-year survival rate of less than 10%.
In another study a team at The Salk Institute has identified a molecule, JQ1, which has shown promise in the prevention as well as reversal of liver fibrosis in animals. This molecule interferes with the master regulator of liver fibrosis, BRD4. This treatment is at the gene level, and works to block fibrosis formation for patients with cirrhosis from alcoholism and hepatitis. Currently JQ1 is a prototype of a new class of drugs tested in human clinical trials for various cancers.1,2
- Gastroenterology (2015) doi: 10.1053/j.gastro.2015.11.038
- Scientists in Barcelona discover a potential treatment for cirrhosis. Institute for Research in Biomedicine Barcelona. Published December 11, 2015.
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