title: The liver-cytokine-brain circuit in interferon-based treatment of patients with chronic viral hepatitis.
abstract: Psychiatric symptoms are commonly identified in patients with viral hepatitis. They may have been present prior to the onset of disease and may include symptoms related to addiction issues. Furthermore, the virus and antiviral therapy, in particular interferon, may induce or modify psychiatric symptoms. Recent data support chronic hepatitis C replication in the brain and subsequent changes of cerebral metabolite spectra and magnetic resonance alterations. In chronic viral hepatitis and in other chronic inflammatory diseases, an alteration of the neuro-endocrine-immune system response has been observed. Catecholamines and glucocorticoids modulate this immune/inflammatory reaction. Psychiatric assessment and monitoring before, during and after antiviral therapy can identify patients whose psychiatric symptoms preclude therapy, and those who may benefit from psychopharmacological therapy and counselling, thereby improving therapeutic results. This review will discuss current insights into the complex interplay between cytokines, liver and brain in chronic viral hepatitis closely associated with psychiatric issues, especially in the case of antiviral therapy, with the aim of indicating future research and possible treatments.
authors.affiliation: Department of Internal Medicine, University of Florence, Florence, Italy. cristina.stasi@unifi.it
authors.forename: C
authors.initials: C
authors.lastname: Stasi
authors.forename: A L
authors.initials: AL
authors.lastname: Zignego
authors.forename: G
authors.initials: G
authors.lastname: Laffi
authors.forename: M
authors.initials: M
authors.lastname: Rosselli
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology / Q000821:virology*; D020805:Central Nervous System Viral Diseases / Q000188:drug therapy; D003345:Corticosterone / Q000378:metabolism; D016174:Hepacivirus / Q000187:drug effects / Q000502:physiology; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000821:virology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use*; D008099:Liver / Q000503:physiopathology / Q000821:virology*; D009682:Magnetic Resonance Spectroscopy; D001523:Mental Disorders / Q000150:complications* / Q000821:virology; D016896:Treatment Outcome; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D000324:Adrenocorticotropic Hormone; D007372:Interferons; D003345:Corticosterone