title: Combined treatment of vitamin K2 and angiotensin-converting enzyme inhibitor ameliorates hepatic dysplastic nodule in a patient with liver cirrhosis.
abstract: Although it is well known that the hepatocellular carcinoma (HCC) is an ominous complication in patients with liver cirrhosis, there has been no approved drug to prevent the development of HCC to date. We previously reported that the combined treatment of vitamin K2 (VK) and angiotensin-converting enzyme inhibitor (ACE-I) significantly suppressed the experimental hepatocarcinogenesis. A 66-year-old Japanese woman with hepatitis C virus (HCV)-related liver cirrhosis developed a dysplastic nodule in the liver detected by enhanced computed tomography along with elevation of the tumor markers, namely, alpha-fetoprotein (AFP) and lectin-reactive demarcation (AFP-L3), suggesting the presence of latent HCC. After oral administration of VK and ACE-I, the serum levels of both AFP and AFP-L3 gradually decreased without any marked alteration of the serum aminotransferase activity. After one-year treatment, not only the serum levels of AFP and AFP-L3 returned to the normal ranges, but also the dysplastic nodule disappeared. Since both VK and ACE-I are widely used without serious side effects, this combined regimen may become a new strategy for chemoprevention against HCC.
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: Masaharu
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ikenaka
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Sawai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Hideto
authors.initials: H
authors.lastname: Kawaratani
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Mashitani
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: Akira
authors.initials: A
authors.lastname: Mitoro
authors.forename: Masahisa
authors.initials: M
authors.lastname: Toyohara
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000188:drug therapy*; D011230:Precancerous Conditions / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D024482:Vitamin K 2 / Q000008:administration & dosage*; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000509:alpha-Fetoproteins; D024482:Vitamin K 2