丙肝发现20年被欧美根治，国肝乙肝40年，还在焦盼！

zgct

　　从目前我收到的反馈来看，本届会议是一次非常成功的会议。大会有很多的亮点，呈现了很多真正吸引人的新发现，无论是临床研究、基础研究，还是转化研究都是如此。
　　① 大会的组织和结构与往年相比有所不同。在为期1天的特殊议题讨论（SIG），我们重点探讨了肝病领域较成功的多学科交叉的研究。
　　② 基础方面，分别以细胞自噬和细胞外囊泡为主题进行了专题研讨会，我们对有关细胞自噬与肝病之间的病理学联系进行了广泛的讨论，细胞外囊泡的研究在肝脏生物学中是一个新兴的领域，它的价值还有待我们探索。
　　③ 大会还有一整天的以临床为导向、以实践为驱动的继续教育课程，我认为这对于广大医务工作者来说有重大价值。
　　④ 大会上，有很多非常有趣的会议议题和体现最高水平的报告，主要包括门静脉高压的治疗、有关肝移植和肝炎免疫抑制治疗等方面的最新进展。
　　This has been a very successful meeting based on the feedback I have received so far. There are multiple highlights. The organization and structure of the meeting were a little bit different from previous years. We offered a full day program for special interest groups on Friday that provided a robust and interactive program that was very well attended. Something new was the three full day program for basic research which included a symposium on basic science with the topic of autophagy which gave a broad overview of the pathology associated with liver disease. The basic research workshop on Sunday was on extracellular vesicles, which is a fascinating new area in liver biology. The post-graduate course ran for an entire day and was very clinically oriented, practically driven and I think of tremendous value to practitioners. For the latest information, there were a lot of really fascinating sessions and state-of-the-art talks that concentrated on the management of portal hypertension, immunosuppression in transplants and hepatitis debriefs and overviews. These were all highlights and I could go on and on because overall, I think there was a lot of really fascinating and new science presented, both in terms of clinical advancements and in translational and basic research.
转化医学是医学发展之路，丙型肝炎的治疗是最成功的案例
　　有关转化医学之价值，可能最成功的例子是有关在丙型肝炎中的应用。1989年，我们才刚刚发现HCV。现在，我们已经有了可以基本上彻底清除HCV的治疗药物。我们希望从中学到有关于转化医学的经验，从而应用于更多类型的肝脏疾病，而不仅仅是病毒性肝炎。
　　对于肝纤维化、酒精性脂肪性肝炎和NASH来说，目前有许多临床前研究者正在努力探索，将基础研究成果转化为临床试验。在本届年会上，我们已经可以看到与纤维化和NASH相关的一些早期临床试验结果，这些新的治疗方法有望进入更大规模的临床试验。
　　In general, the beauty of translational research and probably the best example of the success of that is the hepatitis C story. We discovered the virus in 1989 and now we are at the point of having therapies to essentially totally eliminate the virus. We are hoping that the lessons learned during that process could be applied to many other types of liver disease and not just viral hepatitis. In terms of fibrosis and NASH (I believe we should add alcoholic steatohepatitis to that list), there has been a lot of interest in these diseases and we are relying on the many preclinical investigators working in the field to bring their work to the attention of clinical trials. We have seen that with fibrosis and NASH and some early clinical trial results are evolving paving the way for new therapeutic developments and larger clinical trials.
脂肪肝相关的研究及进展
　　作为美国德克萨斯大学西南医学中心、路易斯维尔大学、克利夫兰医学中心、马萨诸塞大学医学院的四个研究团队的负责人，我们的抗酒精性脂肪性肝炎项目（DASH）正在研究如何鉴定酒精性脂肪性肝病潜在的生物学标志物，这项研究将应用于酒精性脂肪性肝病的诊断和新药的靶向治疗。
　　同时，我们还在开展一些临床前研究的临床试验，其中一项是有关重度酒精性肝炎患者的随机、对照、双盲试验，比较联合应用白介素受体拮抗剂、己酮可可碱和锌补充剂的联合治疗方案与糖皮质激素标准方案的疗效。另一项是关于应用益生菌LGG治疗中度酒精性肝炎的临床试验，希望通过该研究的观察数据以及我们收集患者的样本，分析潜在的预后相关的生物学标志物，最终帮助患者群体。
　　最后，Szabo主席肯定了我国肝病研究专家在病毒性肝炎领域的工作，并对解放军第302医院王福生教授表示了祝贺，赞扬他在病毒性肝炎的免疫学研究、发病机制和干预措施等方面所做的贡献。
　　I have the privilege of being the leader of a consortium which includes four different institutions (University of Texas Southwestern, University of Louisville, the Cleveland Clinic and my institution, the University of Massachusetts Medical School) where we have the DASH program (Defeat Alcoholic SteatoHepatitis) in which we are currently identifying potential biomarkers for alcoholic liver disease. We also have ongoing clinical trials in these patients which are informed from preclinical studies. One of those clinical trials is in the severe alcoholic hepatitis patient population. It is a placebo controlled, double-blind study to test the utility of a combination of interleukin receptor antagonists plus pentoxifylline and zinc supplements compared to standard of care with corticosteroids. We have another ongoing clinical trial in a patient population with moderate alcoholic hepatitis which is also a placebo-controlled trial with a probiotic, lactobacillus GG. We believe by looking at the observational arm of this study and collecting samples from patients, we can analyze those for potential biomarkers which will inform us on how to design future clinical trials to help these patient populations.
　　I congratulate Dr Fu-Sheng Wang who is leading efforts there to bring hepatology to the forefront. I know they do wonderful studies in viral hepatitis and those are the strength of the Institute, particularly approaching that from the translational standpoint and understanding immune markers and mechanisms and interventions.
　　专家简介：
　　Gyongyi Szabo, MD, PhD，美国肝病研究协会（AASLD）现任主席，马萨诸塞大学医学院研究院副院长，临床与转化医学副主任，主要从事酒精性/非酒精性脂肪性肝病、病毒性肝炎的炎症与免疫机制，目前感兴趣领域包括：树突状细胞抗原提呈、酒精性脂肪性肝炎与丙型肝炎的分子机制及其调节，担任Hepatology杂志副主编，已发表文章172篇。

llau_lhf

老外丙肝多，老中乙肝多。

jinabest

能让大家有机会得乙肝活就应该感谢了。

zgct

为什么乙肝受体NTCP这么重要，又得到国际公认，为何三年已过，国际上没有十几个依据受体开发的明星药开始浮头？丙肝受体出现8年，欧美研发的根治药物己完成三期试验了！难道乙肝受体可能有迷雾？

默然10

目估哈，估计这个受体不止这个，病毒感染一般不可能只有一个受体。

zgct

默然10 发表于 2015-11-22 18:46
目估哈，估计这个受体不止这个，病毒感染一般不可能只有一个受体。

估计可能中国乙肝受体仅是其中一小部分受体，还有重要其內部分没发现

MP4

zgct 发表于 2015-11-22 07:22
为什么乙肝受体NTCP这么重要，又得到国际公认，为何三年已过，国际上没有十几个依据受体开发的明星药开始浮 ...

你都说十年一周期为何还要不停反复强调三年？
丙肝和乙肝完全是两类不一样的病毒，一个是RNA病毒，一个是DNA病毒，现在上市丙肝新药不是基于受体，是基于RNA聚合酶抑制的，而乙肝的DNA聚合酶抑制剂就是现在大家常用抗病毒药。同样抑制聚合酶，可亿肝就是没法达到比较彻底，欧美对丙肝研发也比亿肝更重视，所以你这样对比并不合适，亿肝需要考虑别的办法。 我们只是知道它是哪道门进去的，还不知道具体门锁的结构，但是知道哪道门已经是伟大进步。