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Title: Enhanced apoptosis in post-liver transplant hepatitis C: effects of virus and immunosuppressants.
Austin Authors: Lim, Eu Jin ;Chin, Ruth;Angus, Peter W ;Torresi, Joseph 
Affiliation: Victorian Liver Transplant Unit
Infectious Diseases
Issue Date: 14-May-2012
Publication information: World Journal of Gastroenterology 2012; 18(18): 2172-9
Abstract: Hepatitis C (HCV)-infected patients have a poorer survival post-liver transplantation compared to patients transplanted for other indications, since HCV recurrence post-transplant is universal and commonly follows an aggressive course. There is increasing evidence that in the non-transplant setting, induction of hepatocyte apoptosis is one of the main mechanisms by which HCV drives liver inflammation and fibrosis, and that HCV proteins directly promote apoptosis. Recent studies have shown that post-liver transplant, there is a link between high levels of HCV replication, enhanced hepatocyte apoptosis and the subsequent development of rapidly progressive liver fibrosis. Although the responsible mechanisms remain unclear, it is likely that immunosuppressive drugs play an important role. It is well known that immunosuppressants impair immune control of HCV, thereby allowing increased viral replication. However there is also evidence that immunosuppressants may directly induce apoptosis and this may be facilitated by the presence of high levels of HCV replication. Thus HCV and immunosuppressants may synergistically interact to further enhance apoptosis and drive more rapid fibrosis. These findings suggest that modulation of apoptosis within the liver either by changing immunosuppressive therapy or the use of apoptosis inhibitors may help prevent fibrosis progression in patients with post-transplant HCV disease.
DOI: 10.3748/wjg.v18.i18.2172
Journal: World Journal of Gastroenterology
Type: Journal Article
Subjects: Apoptosis
Hepatitis C
Immunosuppressive agents
Liver transplantation
transforming growth factor-β
Apoptosis.drug effects
Immunosuppressive Agents.adverse effects
Liver.drug effects.pathology.virology
Liver Cirrhosis.pathology.virology
Liver Transplantation.adverse effects
Risk Factors
Treatment Outcome
Virus Replication
Appears in Collections:Journal articles

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