Novel Anti-inflammatory Treatments in Cirrhosis. A Literature-Based Study

Abstract

Liver cirrhosis is a disease characterised by multiple complications and a poor prognosis. The prevalence is increasing worldwide. Chronic inflammation is ongoing in liver cirrhosis. No cure for the inflammation is available, and the current treatment of liver cirrhosis is only symptomatic. However, several different medical agents have been suggested as potential healing drugs. The majority are tested in rodents, but few human trials are effectuated. This review focuses on medical agents described in the literature with supposed alleviating and curing effects on liver cirrhosis. Twelve anti-inflammatory, five antioxidative, and three drugs with effects on gut microflora and the LPS pathway were found. Two drugs not categorised by the three former categories were found in addition. In total, 42 rodent studies and seven human trials were found. Promising effects of celecoxib, aspirin, curcumin, kahweol, pentoxifylline, diosmin, statins, emricasan, and silymarin were found in cirrhotic rodent models. Few indices of effects of etanercept, glycyrrhizin arginine salt, and mitoquinone were found. Faecal microbiota transplantation is in increasing searchlight with a supposed potential to alleviate cirrhosis. However, human trials are in demand to verify the findings in this review.

Active Clinical Trials in Hepatic Encephalopathy: Something Old, Something New and Something Borrowed

“…If the positive outcomes are confirmed, it could also open new possibilities to treat HE or mHE patients with liver cirrhosis given that inflammation and immune response have been suggested to play a central role in the pathogenesis of HE, as demonstrated in patients and animal models [6,8,[64][65][66]. Unfortunately, although many nonsteroidal anti-inflammatory drugs, such as ibuprofen or celecoxib, or anti-TNF-α inhibitors, including infliximab or etanercept, which have revolutionized the treatment of multiple inflammatory conditions, including rheumatoid arthritis, psoriasis and inflammatory bowel disease, have shown promising results in animal models of liver disease [6,[67][68][69][70], they have also been associated with different degrees of hepatotoxicity when tested in patients, including the reactivation of viral hepatitis, drug-induced liver injury and de novo autoimmune hepatitis [71][72][73]. Therefore, the fact that only two drugs belonging to this category have reached testing in humans indicates that more efforts are needed to reduce the enormous gap between these and the other and more classical drugs, which still dominate the pharmacological field in HE.…”

PTX Treatment of Colon Cancer: Mode of Action Based on Tumor Marker and Cytokine Kinetics

“…PTX has also been shown to reduce IL-6, TNFα, CRP, and MCP-1 in other diseases such as in non-alcoholic steatohepatitis patients (21) and Cirrhosis (22) and was proposed as an adjunctive therapy in patients with irritable bowel syndrome (23) and in preterm neonates with suspected late onset sepsis (24). PTX is included in the preliminary drugs used for the treatment of the recent global pandemic COVID-19 (25)(26)(27)(28)(29).…”