title: S-adenosyl-L-methionine treatment for alcoholic liver disease: a double-blinded, randomized, placebo-controlled trial.
abstract: BACKGROUND
  S-adenosyl-L-methionine (SAM) is the methyl donor for all methylation reactions and regulates the synthesis of glutathione, the main cellular antioxidant. Previous experimental studies suggested that SAM may benefit patients with established alcoholic liver diseases (ALDs). The aim of this study was to determine the efficacy of SAM in treatment for ALD in a 24-week trial. The primary endpoints were changes in serum aminotransferase levels and liver histopathology scores, and the secondary endpoints were changes in serum levels of methionine metabolites.
  
  
  METHODS
  We randomized 37 patients with ALD to receive 1.2 g of SAM by mouth or placebo daily. Subjects were required to remain abstinent from alcohol drinking. A baseline liver biopsy was performed in 24 subjects, and a posttreatment liver biopsy was performed in 14 subjects.
  
  
  RESULTS
  Fasting serum SAM levels were increased over timed intervals in the SAM treatment group. The entire cohort showed an overall improvement of AST, ALT, and bilirubin levels after 24 weeks of treatment, but there were no differences between the treatment groups in any clinical or biochemical parameters nor any intra- or intergroup differences or changes in liver histopathology scores for steatosis, inflammation, fibrosis, and Mallory-Denk hyaline bodies.
  
  
  CONCLUSIONS
  Whereas abstinence improved liver function, 24 weeks of therapy with SAM was no more effective than placebo in the treatment for ALD.
authors: Department of Internal Medicine, University of California Davis, Sacramento, California 95817, USA. valentina.medici@ucdmc.ucdavis.edu
authors: Valentina
authors: V
authors: Medici
authors: Maria C
authors: MC
authors: Virata
authors: Janet M
authors: JM
authors: Peerson
authors: Sally P
authors: SP
authors: Stabler
authors: Samuel W
authors: SW
authors: French
authors: Jesse F
authors: JF
authors: Gregory
authors: Anthony
authors: A
authors: Albanese
authors: Christopher L
authors: CL
authors: Bowlus
authors: Sridevi
authors: S
authors: Devaraj
authors: Edward A
authors: EA
authors: Panacek
authors: John R
authors: JR
authors: Richards
authors: Charles H
authors: CH
authors: Halsted
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D008715:Methionine / Q000378:metabolism; D008875:Middle Aged; D012189:Retrospective Studies; D012436:S-Adenosylmethionine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012436:S-Adenosylmethionine; D008715:Methionine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase