ABSTRACT

Introduction: Oxidative stress underlies the pathophysiology of various etiologies of chronic liver disease and contributes to the development of hepatocarcinogenesis.

Areas covered: This review focuses on the impact of oxidative stress in various etiologies of chronic liver disease such as alcoholic liver disease (ALD), nonalcoholic steatohepatitis (NASH), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection. The efficacy of antioxidants in laboratory, animal, and clinical studies in chronic liver disease is also reviewed.

Expert opinion: Currently, there are limited targeted pharmacotherapeutics for NASH and no pharmacotherapeutics for ALD and antioxidant supplementation may be useful in these conditions to improve liver function and reverse fibrosis. Antioxidants may also be used in patients with HBV or HCV infection to supplement antiviral therapies. Specific genotypes of antioxidant and prooxidant genes render patients more susceptible to liver cirrhosis and hepatocellular carcinoma while other individual characteristics like age, genotype, and metabolomic profiling can influence the efficacy of antioxidants on CLD. More research needs to be done to establish the safety, efficacy, and dosage of antioxidants and to establish the ideal patient profile that will benefit the most from antioxidant treatment.

摘要

简介： 氧化应激是慢性肝病各种病因的病理生理学基础，并有助于肝癌的发生。

涵盖的领域：本综述重点关注氧化应激对各种慢性肝病病因的影响，例如酒精性肝病 (ALD)、非酒精性脂肪性肝炎 (NASH)、乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 感染。还回顾了抗氧化剂在慢性肝病的实验室、动物和临床研究中的功效。

专家意见：目前，针对 NASH 的靶向药物治疗有限，没有针对 ALD 的药物治疗和抗氧化剂补充剂可能有助于改善肝功能和逆转纤维化。抗氧化剂也可用于 HBV 或 HCV 感染患者以补充抗病毒治疗。抗氧化剂和促氧化剂基因的特定基因型使患者更容易患肝硬化和肝细胞癌，而其他个体特征如年龄、基因型和代谢组学分析会影响抗氧化剂对 CLD 的功效。需要做更多的研究来确定抗氧化剂的安全性、有效性和剂量，并确定最能从抗氧化剂治疗中受益的理想患者概况。