Advertisement

Andere therapeutische Ansätze bei chronisch-aktiver Hepatitis

  • R. Müller
Conference paper

Zusammenfassung

In den letzten Jahren haben mehrere Arbeitsgruppen versucht, den Verlauf einer chronisch-aktiven Hepatitis (CAH) durch Immunstimulation und im Falle einer chronischen Hepatitis B auch durch eine antivirale Behandlung günstig zu beeinflussen. Die Anregung des Immunapparates durch das Absetzen einer immunsuppressiven Medikation wurde schon im vorausgehenden Referat von Prof. Vido besprochen. Als Immunstimulanzien wurden darüber hinaus Laevamisol, verschiedene bakterielle Antigene, Transferfaktor und informatorische RNS (I-RNS) eingesetzt. Laevamisol soll die T-Zellaktivität und die Phagozytosefähigkeit von Monozyten und Makrophagen steigern. Die Ergebnisse aller Studien, in denen diese Substanz eingesetzt wurde, stimmen darin überein, daß sich ein günstiger therapeutischer Effekt bei chronisch-aktiver Hepatitis nicht erzielen läßt (Javor et al. 1978; Piccari et al. 1979; Ponzetto et al. 1979; Fattovich et al. 1981). Die Therapie mußte bei einigen Patienten wegen Übelkeit und exanthematischen Hautausschlägen abgebrochen werden. In einem Fall wurde eine Agranulozytose beschrieben (Nilius et al. 1983).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Bassendine MF, Chadwick RG, Salmeron J, Shipton U, Thomas C, Sherlock S (1979) Treatment of HBsAg-positive chronic liver disease with adenine arabinoside. Gut 20: 906Google Scholar
  2. Brechot C, Hadchonel M, Scotte J, Fonck M, Potet F, Vyas GN, Tiollais P (1981a) State of hepatitis B virus DNA in hepatocytes of patients with hepatitis B surface antigen-positive and -negative liver disease. Proc Natl Acad Sci USA 78: 2906CrossRefGoogle Scholar
  3. Brechot C, Hadchonel M, Scotto J, Degos F, Charnay P, Trepo C, Tiollais P (1981b) Detection of hepatitis B virus DNA in liver and serum. Lancet II:765Google Scholar
  4. Brzosko WJ, Debski R, Derecka K (1978) Immunstimulation for chronic active hepatitis. Lancet II:311Google Scholar
  5. Chadwick RG, Bassendine MF, Crawford EM, Thomas HC, Sherlock S (1978) HBsAg-positive chronic liver disease: Inhibition of DNA polymerase activity by vidarabine. Br Med J II: 531CrossRefGoogle Scholar
  6. Desmyter J, DeGroote J, Demet VJ et al. (1976) Administration of human fibrobalst interferon in chronic hepatitis B infection. Lancet 1I: 645CrossRefGoogle Scholar
  7. Dolen J, Carter GWA, Horoszewicz JS, Vladutin AO, Leibowitz AI, Nolan JP (1979) Fibroblast interferon treatment of a patient with chronic active hepatitis. Am J Med 67: 127PubMedCrossRefGoogle Scholar
  8. Eisenburg J (1979) Behandlung der Virushepatitis. Bew?hrte Methoden and neue Wege. Fortschr Med 97:1363PubMedGoogle Scholar
  9. Fattovich G, Crivellaro C, Cadrobbi P, Pornaro E, Alberti A, Realdi G (1981) Virological changes in HBsAg-positive active hepatitis in childhood during levamisole-treatment (Abstract). EASL, LissabonGoogle Scholar
  10. Gil J, Ziemka J, Brzosko J et al. (to be published) Immunotherapy of chronic active viral hepatitis B with propioni-bacterium granulosum. HepatogastroenterologyGoogle Scholar
  11. Greenberg HB, Pollard RB, Lutwick LI, Gregory PB, Robinson WS, Merigan TC (1976) Effect of human leukocyte interferon on hepatitis B virus infection in patients with chronic active hepatitis. N Engl J Med 295: 517PubMedCrossRefGoogle Scholar
  12. Javor R, Pear A, Bajtai G, Amburg M, Hollós I, Kovâvs M (1978) Immunstimulation als therapeutisches Prinzip bei der chronischen Hepatitis. Wiss Z Ernst Moritz Arndt Universität Greifswald 27: 105Google Scholar
  13. Kato Y, Kobayashi K, Suyama T, Hattori N (1979) Effects of human leukocyte interferon therapy on hepatitis B virus in patients with chronic active hepatitis. Gastroenterology 77: 21Google Scholar
  14. Kingham JGC, Ganguly NK, Shaari ZD et al. (1978) Treatment of HBsAg-positive chronic active hepatitis with human fibroblast interferon. Gut 19: 91PubMedCrossRefGoogle Scholar
  15. Kondo M, Matsumura N, Yoshikawa T, Nishida K, Tagami H (1980) Effect of human leukocyte interferon on hepatitis surface antigen. Hepatogastroentrology Abstracts of the XI. Internat. Congress of Gastroenterology, Hamburg, June 8–13. 1980. Thieme, Stuttgart New York, p 353Google Scholar
  16. Koshy R, Kaupas P, Müller R, Hofschneider PH (1981) Detection of hepatitis B virus specific DNA in the genomes of human hepatocellular carcinoma and liver cirrhosis tissue. J Gen Virol 57: 95PubMedCrossRefGoogle Scholar
  17. Lok ASF, Karayiannis P, Brown D, Fowler MJF, Monjardino J, Thomas HC, Sherlock S (1983) Suppression of hepatitis B virus (HBV) replication with thrice weekly lymphoblastoid interferon (Abstract W 9 ). EASL, SouthamptonGoogle Scholar
  18. Müller R (1980) Neue Aspekte der Therapie von Virushepatitiden. Mitt Klin Nephrol 9: 108Google Scholar
  19. Müller R, Vido I, Siegert W, Wöltje M, Klein H, Staar U, Schmidt FW (1980) Exogenous interferon in chronic hepatitis B infection. In: Bianchi L, Gerok W, Sickinger K, Stalder GA (eds) Virus and the liver. MTP Press, Lancester, p 355Google Scholar
  20. Müller R, Siegert W, Hofschneider HP, Deinhardt F, Frösner G, Vido I, Schmidt FW (1981) Treatment of chronic active hepatitis B (CAHB) with human interferon-beta. In: DeMeyer E, Galazzo G, Schellekens H (eds) The biology of the interferon system. Elsevier/ North Holland, Amsterdam, p 355Google Scholar
  21. Müller R, Vido I, Klein H, Wille E, Schmidt FW (1983) Human interferon-beta (HIFN-ß) and adenine arabinoside 5’-monophosphate (ARA-AMP) in HBsAg chronic active hepatitis (CAH) (Abstract W 10 ). EASL, SouthamptonGoogle Scholar
  22. Nilius R, Schentke U, Otto L et al. (1983) Levamisole therapy in chronic hepatitis. Results of a multicentric double blind trial. Hepatogastroenterology 30: 90PubMedGoogle Scholar
  23. Piccari GG, D’Imperio N, Formica G, Piemontese A, Sarti F, Spongano P, Del Monte PR (1979) Levamisole therapy in chronic active liver diseases (Abstract). EASL, DüsseldorfGoogle Scholar
  24. Pizza G, Viza D, Roda A, Aldini E, Roda E, Barbara L (1979) Transfer factor for the treatment of chronic active heaptitis. N Engl J Med 300: 1332PubMedGoogle Scholar
  25. Pollard RB, Smith JL, Neal EA, Gregory PB, Merigan TC, Robinson WS (1978) Effect of vidarabine on chronic hepatitis B virus infection. JAMA 239: 1648PubMedCrossRefGoogle Scholar
  26. Ponzetto A, Bonini F, Arrigoni A et al. (1979) Immunostimulant therapy in HBSAg + chronic active liver disease: A pilot controlled trial with levamisole (Abstract). EASL, DüsseldorfGoogle Scholar
  27. Schaffner F (1980) New approaches to treatment of hepatitis B chronic liver disease. In: Bianchi L, Gerok W, Sickinger K, Stalder GA (eds) Virus and the liver. MTP Press, Lancaster, p 367Google Scholar
  28. Schober A, Kaboth W, Biswas R, Gerlich W, Stamm B, Creutzfeld W (1979) Treatment of chronic hepatitic B virus (HBV-)-infection with ribavirin. 5. Internat. Congr. of liver diseases Basel, October 1979Google Scholar
  29. Scullard GH, Alberti A, Wansbrough-Jones MH et al. (1979) Effects of human leukocyte interferon in hepatitis B virus replication and immuno responses in patients with chronic hepatitis B infection. J Clin Lab Immunol 1: 227Google Scholar
  30. Scullard GH, Andres LL, Greenberg HB et al. (1981a) Antiviral treatment of chronic hepatitis B virus infection: Improvement in liver disease with interferon and adenine arabinoside. Hepatology 1: 228PubMedCrossRefGoogle Scholar
  31. Scullard GH, Pollard RB, Smith JL, Sacks SL, Gregory PB, Robinson WS, Merigan TC ( 1981 b) Antiviral treatment of chronic hepatitis B virus infection. I. Changes in viral markers with interferon combined with adenine arabinoside. J Infect Dis 143: 772PubMedCrossRefGoogle Scholar
  32. Shulman S, Schulkind M, Ayoub E (1974) Transferfactor therapy of chronic active hepatitis. Lancet II:650Google Scholar
  33. Smith CJ, Kitchen LW, Scullard GH, Robinson WS, Gregory PB, Merigan TC (1982 a) Vidarabine monophosphate and human leukocyte interferon in chronic hepatitis V infection. JAMA 247:2261Google Scholar
  34. Smith CJ, Scullard GH, Gregory PB, Robinson WS, Merigan TC ( 1982 b) Preliminary studies of acyclovir in chronic hepatitis B. Acyclovir Symp. Am J Med 73: 267PubMedCrossRefGoogle Scholar
  35. Sodomann CP, Maerker-Alzer G, Havemann K et al. (1979) Transfer factor treatment of patients with HBsAg positive active hepatitis. Klin Wochenschr 57: 193CrossRefGoogle Scholar
  36. Tong MJ, Nastrom JS, Redecker AG, Marshall GJ (1976) Failure of transfer factor therapy in chronic active B hepatitis. N Engl J Med 295: 209PubMedCrossRefGoogle Scholar
  37. Toshitsugu ODA (1980) Effect of human leukocyte or fibroblast interferon on hepatitis B virus infection in patients with chronic hepatitis. Conference on clinical and malignant tumors. Osio, Japan, December 2–4, 1980Google Scholar
  38. Trepo C, Hantz O, Coupier D, Chossegros P, Chevallier R, Brette R (1983) Comparative tolerance and efficiacy studies of ARA-A, ARA-AMP, acyclovir and leucocyte interferon on HBV replication (Abstract W 12 ). EASL, SouthamptonGoogle Scholar
  39. Watanabe S, Saito S, Yoshikawa A, Shibayama T, Kamimura T, Suziki S, Ischida F (1982) Evaluation of the antiviral effects of adenine arabinoside on chronic HBV infection. Hepatogastroenterology 29: 102PubMedGoogle Scholar
  40. Weimar W, Heijtink RA, Schalm SW et al. (1977) Fibroblast interferon in HBsAg-positive chronic active hepatitis. Lancet II:1282CrossRefGoogle Scholar
  41. Weimar W, Heijtink RA, Schalm SW, Schellekens H (1978) Differential effect of exogenous fibroblast and leukocyte interferon in HBsAg chronic hepatitis. Gastroenterology 74: 1150Google Scholar
  42. Weimar W, Heijtink RA, Schalm SW, Schellekens H (1979) Differential effects of fibroblast and leukocyte interferon in HBsAg positive chronic active hepatitis. Eur J Clin Invest 9: 151PubMedCrossRefGoogle Scholar
  43. Weller ND, Bassendine MF, Murray AR, Summers J, Thomas HC, Sherlock S (1980) HBsAg positive chronic liver disease inhibition of viral replication by highly soluble adenine arabinoside 5’-monophosphate ( ARA-AMP ). Gastroenterology 79: 1129Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • R. Müller

There are no affiliations available

Personalised recommendations