首页|Enhanced apoptosis in post-liver transplant hepatitis C:Effects of virus and immunosuppressants

Enhanced apoptosis in post-liver transplant hepatitis C:Effects of virus and immunosuppressants

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Hepatitis C (HCV)-infected patients have a poorer survival post-liver transplantation compared to patients transplanted for other indications,since HCV recurrence post-transplant is universal and commonly follows an aggressive course.There is increasing evidence that in the non-transplant setting,induction of hepatocyte apoptosis is one of the main mechanisms by which HCV drives liver inflammation and fibrosis,and that HCV proteins directly promote apoptosis.Recent studies have shown that post-liver transplant,there is a link between high levels of HCV replication,enhanced hepatocyte apoptosis and the subsequent development of rapidly progressive liver fibrosis.Although the responsible mechanisms remain unclear,it is likely that immunosuppressive drugs play an important role.It is well known that immunosuppressants impair immune control of HCV,thereby allowing increased viral replication.However there is also evidence that immunosuppressants may directly induce apoptosis and this may be facilitated by the presence of high levels of HCV replication.Thus HCV and immunosuppressants may synergistically interact to further enhance apoptosis and drive more rapid fibrosis.These findings suggest that modulation of apoptosis within the liver either by changing immunosuppressive therapy or the use of apoptosis inhibitors may help prevent fibrosis progression in patients with post-transplant HCV disease.

Hepatitis CLiver transplantationApoptosisImmunosuppressive agentstransforming growth factor-β

Eu Jin Lim、Ruth Chin、Peter W Angus、Joseph Torresi

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Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia

Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3084,Australia

Department of Medicine, University of Melbourne,Austin Health, Heidelberg, Victoria 3084, Australia

Department of Infectious Diseases, Austin Hospital, Heidelberg, Victoria 3084, Australia

Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria 3084, Australia

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2012

10.3748/wjg.v18.i18.2172

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(18)
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