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Beneficial effects of candesartan, an angiotensin-blocking agent, on compensated alcoholic liver fibrosis - a

Moon Young Kim1, Mee Yon Cho, Soon Koo Baik

  • 1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.

Liver International : Official Journal of the International Association for the Study of the Liver
|February 28, 2012
PubMed
Abstract

Insights

Angiotensin II type 1 receptor (AT1-R) blocking agents, like candesartan, significantly improve liver fibrosis in patients with alcoholic liver disease. This study demonstrates the antifibrotic effects of ARB in human subjects.

Area of Science:

  • Hepatology
  • Pharmacology
  • Fibrosis Research

Background:

  • The renin-angiotensin system is implicated in hepatic fibrogenesis.
  • Previous research on antifibrotic effects was limited in human alcoholic liver disease models.

Purpose of the Study:

  • To investigate the antifibrotic effect of angiotensin II type 1 receptor (AT1-R) blocking agents (ARB) in patients with alcoholic liver disease.
  • To assess the efficacy of candesartan in improving liver fibrosis.

Main Methods:

  • Eighty-five patients with compensated alcoholic liver fibrosis (≥ F2) were randomized.
  • Patients received either candesartan (8 mg/day) with ursodeoxycholic acid (UDCA) (600 mg/day) or UDCA alone for 6 months.
  • Liver biopsies were performed at baseline and follow-up to assess histological features.

Main Results:

  • Candesartan showed significantly higher rates of histological improvement (33.3% vs. 11.6%, P = 0.020).
  • The fibrosis score, fibrosis area, and α-smooth muscle actin positive area were significantly reduced in the candesartan group.
  • Gene expression of fibrogenic markers (TGF-β1, collagen-1, AT1-R) decreased, with no significant side effects observed.

Conclusions:

  • Administration of ARB in compensated alcoholic liver disease improves fibrosis.
  • Candesartan demonstrates significant antifibrotic effects in histological and quantitative measurements.
  • ARB therapy is a promising approach for managing alcoholic liver disease fibrosis.

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