抗肿瘤坏死因子（TNF）-α对肝脏的危害及潜在益处

StephenW

Int J Mol Sci. 2018 Jul 27;19(8). pii: E2199. doi: 10.3390/ijms19082199.
Harmful Effects and Potential Benefits of Anti-Tumor Necrosis Factor (TNF)-α on the Liver.
Lopetuso LR1, Mocci G2, Marzo M3, D'Aversa F4, Rapaccini GL5, Guidi L6, Armuzzi A7, Gasbarrini A8, Papa A9.
Author information

1
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
2
    Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy. [email protected].
3
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
4
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
5
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
6
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
7
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
8
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].
9
    Internal Medicine and Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Roma, Italy. [email protected].

Abstract

Anti-tumor necrosis factor (TNF)-α agents represent an effective treatment for chronic inflammatory diseases. However, some concerns about their potentially undesirable effects on liver function have been reported. On the other hand, evidence of their therapeutic effects on certain liver diseases is accumulating. Many data showed the safety of anti-TNF-α in patients with chronic hepatitis B and C and in liver transplanted patients even if a strict follow-up and prophylaxis are recommended in well-defined subgroups. On the other side, anti-TNF-α-induced liver injury is not a rare event. However, it is often reversible after anti-TNF-α withdrawal. Anti-TNF-α agents have been tested in advanced stages of severe alcoholic hepatitis and non-alcoholic fatty liver disease. Limited data on the efficacy of anti-TNF-α in patients with autoimmune hepatitis and primary biliary cholangitis are also available. In this review, we explored the hepatic safety concerns in patients receiving anti-TNF-α agents with and without pre-existent hepatic diseases. In addition, the available evidence on their potential benefits in the treatment of specific hepatic diseases is discussed.
KEYWORDS:

adalimumab; alcoholic hepatitis; autoimmune hepatitis; certolizumab pegol; drug-induced liver injury; etanercept; golimumab; hepatitis B virus; hepatitis C virus; infliximab; non-alcoholic fatty liver disease

PMID:
    30060508
DOI:
    10.3390/ijms19082199

StephenW

Int J Mol Sci。 2018年7月27日; 19（8）。 pii：E2199。 doi：10.3390 / ijms19082199。
抗肿瘤坏死因子（TNF）-α对肝脏的危害及潜在益处。
Lopetuso LR1，Mocci G2，Marzo M3，D'Aversa F4，Rapaccini GL5，Guidi L6，Armuzzi A7，Gasbarrini A8，Papa A9。
作者信息

1
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
2
    布罗兹医院消化内科，09121卡利亚里，意大利。 [email protected]。
3
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
4
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
五
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
6
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
7
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
8
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。
9
    内科和消化内科，Fondazione Policlinico Universitario A. Gemelli IRCCS-UniversitàCattolicadel Sacro Cuore，00168 Roma，Italy。 [email protected]。

抽象

抗肿瘤坏死因子（TNF）-α剂代表慢性炎性疾病的有效治疗。然而，已经报道了一些关于它们对肝功能的潜在不良作用的担忧。另一方面，它们对某些肝脏疾病的治疗效果的证据正在积累。许多数据显示慢性乙型肝炎和丙型肝炎患者以及肝移植患者中抗TNF-α的安全性，即使在明确定义的亚组中建议进行严格的随访和预防。另一方面，抗TNF-α诱导的肝损伤并不罕见。然而，在抗TNF-α戒断后，它通常是可逆的。已经在严重酒精性肝炎和非酒精性脂肪肝疾病的晚期阶段测试了抗TNF-α剂。关于抗TNF-α在自身免疫性肝炎和原发性胆汁性胆管炎患者中的功效的有限数据也是可行的。在这篇综述中，我们探讨了接受抗TNF-α药物治疗的患者的肝脏安全问题，这些患者有或没有先前存在的肝脏疾病。此外，还讨论了有关其在治疗特定肝病方面的潜在益处的现有证据。
关键词：

阿达木单抗。酒精性肝炎;自身免疫性肝炎; certolizumab pegol;药物性肝损伤;依那西普;戈利木单抗;乙型肝炎病毒;丙型肝炎病毒;英夫利昔单抗;非酒精性脂肪肝病

结论：
    30060508
DOI：
    10.3390 / ijms19082199