title: Interferon augments the anti-fibrotic activity of an angiotensin-converting enzyme inhibitor in patients with refractory chronic hepatitis C.
abstract: OBJECTIVE
  To evaluate the effect of combination treatment with the interferon (IFN) and angiotensin-converting enzyme inhibitor (ACE-I) on several fibrotic indices in patients with refractory chronic hepatitis C (CHC).
  
  
  METHODS
  Perindopril (an ACE-I; 4 mg/d) and/or natural IFN (3 MU/L; 3 times a week) were administered for 12 mo to refractory CHC patients, and several indices of serum fibrosis markers were analyzed.
  
  
  RESULTS
  ACE-I decreased the serum fibrosis markers, whereas single treatment with IFN did not exert these inhibitory effects. However, IFN significantly augmented the effects of ACE-I, and the combination treatment exerted the most potent inhibitory effects. The serum levels of alanine transaminase and HCV-RNA were not significantly different between the groups, whereas the plasma level of transforming growth factor-beta was significantly attenuated almost in parallel with suppression of the serum fibrosis markers.
  
  
  CONCLUSIONS
  The combination therapy of an ACE-I and IFN may have a diverse effect on disease progression in patients with CHC refractory to IFN therapy through its anti-fibrotic effect.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan. yoshijih@naramed-u.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshiji
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Noguchi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kojima
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ikenaka
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Kitade
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kaji
authors.forename: Masahito
authors.initials: M
authors.lastname: Uemura
authors.forename: Junichi
authors.initials: J
authors.lastname: Yamao
authors.forename: Masao
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Masahisa
authors.initials: M
authors.lastname: Toyohara
authors.forename: Akira
authors.initials: A
authors.lastname: Mitoro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D004351:Drug Resistance; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*; D016212:Transforming Growth Factor beta / Q000097:blood
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000998:Antiviral Agents; D016212:Transforming Growth Factor beta; D007372:Interferons; D020913:Perindopril