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New Hope for Liver Scars
Those with chronic liver disease can pray for the reversal of liver fibrosis, but new research gives hope for a more scientific approach.
The human liver is capable of recovering from an injury, but chronic liver disease repeatedly challenges this ability. Any continual threat to the liver’s well-being can progressively scar liver tissue, eventually rendering that tissue unable to function. The lack of effective pharmaceutical treatments capable of stopping or reversing liver damage means that liver health efforts primarily target liver injury prevention. However, a study led by researchers at the University of California at San Diego has revealed a potential solution for helping heal the liver, inspiring new hope in those with chronic liver disease.
Understanding Liver Scarring
Toxin exposure, oxidation and other occasional threats that can harm liver cells is part of our everyday experience. Normally, injured liver cells don’t present much of a problem because the liver is capable of regeneration. However, when the rate of liver cell injury outpaces the liver’s regenerative capacity, scars form. Known technically as liver fibrosis, scarring is the body’s attempt to keep the damage done to liver cells contained. However, repeated scarring can block blood flow through the liver and lead to damaged liver tissue that can no longer perform its duties.
Although there are a wide range of potential culprits, chronic liver disease is frequently due to fatty liver, chronic viral hepatitis or alcohol abuse. With chronic liver disease, normal liver regeneration may not occur because hepatic stellate cells become activated and launch an inflammatory and fibrotic cascade. This cascade eventually results in the buildup of collagen scar tissue in the liver. Once activated, hepatic stellate cells acquire characteristics of another cell type called myofibroblasts – cells that abundantly produce extracellular matrix proteins such as collagen. These proteins accumulate as scar tissue and cause organ dysfunction. When fibrosis has advanced to the point where the liver has hardened and shrunk, and can no longer function adequately, the scarring has progressed to cirrhosis – a hallmark of advanced liver disease.
Liver Scarring Reversal
The exact moment at which fibrosis becomes irreversible is unknown. Dense cirrhosis is generally considered to be permanent, but less severe scarring has demonstrated an amazing reversibility when the underlying cause of chronic liver disease is halted.
Although effective pharmacologic interventions that help liver scars heal have not yet materialized, researchers are in desperate pursuit. In the meantime, anti-fibrotic therapies are typically focused on suppressing inflammation in the liver. In addition to stopping the underlying liver disease cause and suppressing inflammation, treatment goals for fibrosis may include hepatic stellate cell destruction and breaking down collagenous liver scars. However, new research has just found another possible strategy for healing liver fibrosis.
Myofibroblast Inactivation
Published in the May 7, 2012 online Early Edition of the Proceedings of the National Academy of Sciences, research led by the University of California, San Diego School of Medicine investigated myofibroblasts – the cells that produce the fibrous scarring in chronic liver injury.
As described earlier, the successful treatment or elimination of chronic liver disease can permit the liver to repair itself. Experts used to believe this repair was partially due to the activated hepatic stellate cells dying and being removed by other cells. However, according to Tatiana Kisseleva, MD, PhD, an assistant research scientist and first author of this study, that is not entirely accurate:
• The San Diego based research study found that even after a liver disease cause is removed, up to half of activated hepatic stellate cells (myofibroblasts) persist. These remaining myofibroblasts revert to an inactive state.
• After one month of myofibroblast inactivity, these cells stop producing collagen and return to their normal location.
• The inactive myofibroblasts are more vulnerable to repetitive injury than hepatic stellate cells that had never been activated.
Nonetheless, this breakthrough study gives scientists on the hunt for ways to reverse liver scarring an additional tool: reverting myofibroblasts to an inactive state.
Since liver fibrosis is the 12th leading cause of death in the United States, all efforts to help those affected warrant investigation. Preventing liver damage, devising better treatments for the causes of chronic liver disease, quelling liver inflammation, destroying activated hepatic stellate cells and metabolizing the fibrous matrix of liver scars has not yet revealed a successful formula for reversing liver fibrosis. However, finding a way to influence myofibroblasts to regress could be the missing piece needed to finally achieve the healing of liver scars.
http://health.ucsd.edu/news/releases/Pages/2012-05-07-scarring-cells-revert-as-liver-heals.aspx, Scarring Cells Revert To Inactive State As Liver Heals, Retrieved May 12, 2012, University of California, San Diego, 2012.
http://www.liverdisease.com/cirrhosis_hepatitis.html, What is Cirrhosis?, Retrieved May 13, 2012, Melissa Palmer, MD, 2012.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1899462/, The Myofibroblast, Boris Hinz, et al, Retrieved May 13, 2012, American Journal of Pathology, June 2007.
http://www.universityofcalifornia.edu/news/article/25240, Cholesterol Regulator key in liver, scarring, cirrhosis, Retrieved May 13, 2012, Regents of the University of California, 2012.
http://www.uptodate.com/contents/emerging-therapies-for-hepatic-fibrosis, Emerging Therapies for Hepatic Fibrosis, Retrieved May 13, 2012, UpToDate, Inc., 2012.
About the Author
Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.
Having been diagnosed with Hep C and stage 4 cirrhosis of the liver, I contacted UCSD for a possible slot in their Hep C research study (2012). Luckily I was accepted for a course of 12 week treatments and was given a secret little white pill and a dose of Ribavirin. There were no shots or other treatments, just 5 little pills a day. Every week my Hep C viral load dropped exponentially, from 2 million to 40,000, 40,000 to 800, 800 to 40, then no detectible virus. 5 months later I still have no detectible virus and feel like I could build a battleship with just a knife and a piece of rope. The only thing that concerns me now is my cirrhosis, and I am glad the brilliant scientists at UCSD are making progress to maybe one day reversing my stage 4 problem. I feel like I owe them big time as they saved my life and I am so grateful for that. Bravo UCSD!!
Bravo. Hi there I’m in the exact situation 4 months hcv-RNA free. Cirrhosis is no reversal but to eliminate the viral load is giving us more time. I have now on my 5th visit for the banding of varices in the esopheal. Have also ascites, portal hypertension. But it’s one day at a time. Get back with me . I also have blood work every month at u of Miami. Great place with doctors and not politicians.
Congratulations AS, that is awesome news.
Still alive, buddy? I’m sure we’d all like to know how you’re doing.
where are you now? Has anyone else been reading the rsk inhibitory peptide to reverse cirrihosis?
I went through Interferon, Ribovirin for many weeks, with a V.L. of about 500,000 it dropped to undetecatable levels then after a few months, right back to 350,000. Type 1 hep c and they knew what was going to happen and never told me.MUSC did the treatments. Now I am needing some type of medical help to get myself healthy again. I take the Milk Thistle and no drinking at all for years. Who can I contact to get hooked up with some sort of experimental treatments. I run a charter fishing service and at the end of the season I am really beat down.
Any help out there for me?
Look at the new hep c cure olysio 150 mg capsule and sovaldi 400mg tablet. 20 years of hep c virus load 500000 and in less than 8 weeks went to zero detectable. I’m 57 and have all other factors of. Cirrhosis. Hope this is helpful for ya. Get back when u need a few more answers.
Contact Dr. Andrew Muir at Duke Medical Center – or the hepatology team there. They can give you the information to direct you to those places you are seeking.
To A S. Could you be more specific about the UCSD treatment? To whom did you contact there? Thank you for the info.
could you tell me what UCSD treatment is? I also have stage 4 liver diease and its getting worse! HELP with the info.
I’m so glad I read these comments. I have Fanta C too (my cutesy little name for it) lol. Call the hospital for information. My friend went to San Diego, and the they hooked him up in Trial. He’s Fanta C free-yeaaaaa.
Anyway, cl UCSD or UCLA–the man in charge is awesome. Dr. Leonard Goldstein. That’s where I go. He’s very cautious with your meds; doesn’t want to hurt your body. And Tom, check out the Milk Thistle more carefully. I read both yea and nay for that : ) CONGRATS A C-back to life again, omg, how sweet! Muah, hang in Babies, peace
Aw, good luck! Three years later, how’s stuff?
Hi! I like your sense of humor!!! I have been taking Silymarin and Milk Thistle for umpteen years now and I just read that they believe it does actually help with hep c and cirrohosis!!(can’t spell) LOL! I was wondering if anyone has heard if collagen hurts your liver, since disease takes our collagen and causes the the scaring of the liver. I was thinking if you put more collagen back in body to make your body stronger if that would hurt or help? Any advice would be appreciated!! Bless You!! We are all on a journey…..
i have hepc and cirrosis stage 4 went thru treatment for 24 weeks was hepc during treatment then numbers went up right after treatment would love to join a study group contacted 30 yrs ago a needle prick undiagnosed for all that time until 2 yrs ago.. the hepc has affected my life in so many ways i cant even discribe.. please help i am 56 yrs old and want a chance
that is awsome.iam 54 years old and got hep c at 19 i got a biopsy a couple years ago only inflamation but the doctor didnt have any good news said i would need a transplant in about 5 yrs ya.well anyway i started getting a aching pain on right side goin to give them a call thanks for the info god bless you
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