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dc.contributor.authorLim, Eu Jinen
dc.contributor.authorChin, Ruthen
dc.contributor.authorAngus, Peter Wen
dc.contributor.authorTorresi, Josephen
dc.identifier.citationWorld Journal of Gastroenterology 2012; 18(18): 2172-9en
dc.description.abstractHepatitis 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.en
dc.subject.otherHepatitis Cen
dc.subject.otherImmunosuppressive agentsen
dc.subject.otherLiver transplantationen
dc.subject.othertransforming growth factor-βen
dc.subject.otherApoptosis.drug effectsen
dc.subject.otherHepatitis C.complications.diagnosis.surgeryen
dc.subject.otherImmunosuppressive Agents.adverse effectsen
dc.subject.otherLiver.drug effects.pathology.virologyen
dc.subject.otherLiver Cirrhosis.pathology.virologyen
dc.subject.otherLiver Transplantation.adverse effectsen
dc.subject.otherRisk Factorsen
dc.subject.otherTreatment Outcomeen
dc.subject.otherVirus Replicationen
dc.titleEnhanced apoptosis in post-liver transplant hepatitis C: effects of virus and immunosuppressants.en
dc.typeJournal Articleen
dc.identifier.journaltitleWorld Journal of Gastroenterologyen
dc.identifier.affiliationVictorian Liver Transplant Unit, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Articleen
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications- Liver Transplant Unit- Liver Transplant Unit- and Hepatology- Diseases-
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