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首页> 外文期刊>World Journal of Gastroenterology >Fenofibrate for patients with asymptomatic primary biliary cirrhosis
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Fenofibrate for patients with asymptomatic primary biliary cirrhosis

机译：非诺贝特治疗无症状原发性胆汁性肝硬化

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AIM: Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of autoimmune etiology, the histology of which shows a destruction of the intrahepatic bile duct and portal inflammation. Ursodeoxycholic acid (UDCA) is now used as a first-line drug for asymptomatic PBC (Apbc) because it is reported that UDCA decreases mortality and prolongs the time of liver transplantation. However, only 20-30% of patients respond fully to UDCA. Recently, lipoprotein-lowering agents have been found to be effective for PBC. The aim of this study was to examine the safety and efficacy of fenofibrate, a member of the fibrate class of hypolipidemic and anti-inflammatory agent via peroxysome proliferatory-activated receptor α, in patients with Apbc. METHODS: Fenofibrate was administered for twelve weeks in nine patients with Apbc who failed to respond to UDCA. UDCA was used along with fenofibrate during the study. The data from Apbc patients were analyzed to assess the biochemical effect of fenofibrate during the study. RESULTS: The serum levels of alkaline phosphatase (ALP) (285+114.8 IU/L) and immunoglobulin M (IgM) (255.8 +- 85.9 mg/dl) significantly decreased to 186.9+-76.2 IU/L and 192.9+-67.5 mg/Dl respectively, after fenofibrate treatment in patients with Apbc (P<0.05). Moreover, the titer of antimitochondrial antibody (AMA) also decreased in 4 of 9 patients with Apbc. No adverse reactions were observed in any patients. CONCLUSION: Fenofibrate appears to be significantly effective in treating patients with Apbc who respond incompletely to UDCA alone. Although the mechanism of fenofibrate on Apbc has not yet been fully clarified, combination therapy using fenofibrate and UDCA might be related to the anti-immunological effects, such as the suppression of AMA production as well as its anti-inflammatory effect.
机译：目的：原发性胆汁性肝硬化（PBC）是一种自身免疫性病因的慢性胆汁淤积性疾病，其组织学表现为肝内胆管破坏和门静脉炎症。熊去氧胆酸（UDCA）现在被用作无症状PBC（Apbc）的一线药物，因为据报道，UDCA可以降低死亡率并延长肝移植时间。但是，只有20-30％的患者对UDCA有完全反应。最近，已经发现降低脂蛋白的药物对PBC有效。这项研究的目的是通过过氧化物酶体增殖激活受体α检查非诺贝特（一种属于降血脂和抗炎剂的贝非特类）的安全性和有效性。方法：对9例对UDCA无效的Abbc患者给予非诺贝特治疗12周。在研究期间，UDCA与非诺贝特一起使用。分析来自Apbc患者的数据，以评估研究期间非诺贝特的生化作用。结果：血清碱性磷酸酶（ALP）（285 + 114.8 IU / L）和免疫球蛋白M（IgM）（255.8 +-85.9 mg / dl）的血清水平显着降低至186.9 + -76.2 IU / L和192.9 + -67.5 mg非诺贝特治疗后的Abbc患者的血浆/ Dl值分别为（P <0.05）。此外，抗线粒体抗体（AMA）的滴度在9例Apbc患者中也有4例下降。在任何患者中均未观察到不良反应。结论：非诺贝特似乎对治疗仅对UDCA反应不完全的Apbc患者有效。尽管非诺贝特对Apbc的作用机理尚未完全阐明，但使用非诺贝特和UDCA的联合治疗可能与抗免疫作用有关，例如抑制AMA产生及其抗炎作用。

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