The effects of lifestyle modification and

liver411

[B]vitamin E on cytokines and NASH[/B]

Lifestyle modifications may improve liver enzymes, cholesterol, and plasma
hyaluronic acid levels in patients with NASH, finds a team of investigators
in the August issue of Hepatology

There is little information on plasma or peripheral blood monocyte cytokine
concentrations and production. Nor is there data on attempts to manipulate
proinflammatory cytokines in nonalcoholic steatohepatitis (NASH).

In this study, physicians from the United States evaluated the effects of
diet and aerobic exercise on cytokine profiles and liver enzyme levels.
They examined the effects both with and without 800 IU of vitamin E daily

The team assessed 16 patients with biopsy-proven NASH.

The researchers found that liver function, lipid profiles, and body mass
index significantly improved during the first 6 weeks of therapy. These
then remained stable during the following 6 weeks.
There appeared to be no independent effects of vitamin E supplementation.
Hepatology

In addition, the team determined that plasma hyaluronic acid (HA)
concentrations decreased in parallel with weight loss.

The team also found that plasma tumor necrosis factor (TNF) concentrations
were significantly elevated in patients with NASH. These were found to be
similar to patients with stable alcoholic cirrhosis, but were not as
elevated as in patients with acute alcoholic steatohepatitis (AH).

In addition, they found that although plasma TNF, interleukin 8 (IL-8), and
IL-6 concentrations were all elevated, only plasma IL-6 levels
significantly decreased with therapy.

The peripheral blood monocyte TNF, IL-8, and IL-6 production was also
significantly elevated in patients with NASH, but the team found that this
did not significantly decrease.

They were unable to identify any independent effects of vitamin E in these
patients.

Dr Marcelo Kugelmas's team concluded, "atients with NASH have dysregulated
cytokine metabolism similar to, but less pronounced than abnormalities
documented in AH".

"Cytokine values generally did not decrease significantly with weight loss
with or without vitamin E over the duration of the study".

"Lifestyle modifications--were associated with improvement in liver
enzymes, cholesterol, and plasma HA levels in patients with NASH".

"Vitamin E supplementation used in this short-term pilot study provided no
apparent added benefit".

Hepatology 2003; 38: 413-19
29 July 2003

"Enlightenment does not come 'by imagining figures of light but by making
the darkness conscious.'"  (Jung)