Prevention of Progression in Chronic Liver Disease
In several liver diseases, the underlying cause cannot always be eliminated, i.e. the progression of liver disease cannot be prevented. This is particularly true for non-responders to the treatment of chronic hepatitis C (HCV). It is relevant for more than 40% of patients with HCV genotype 1 and up to 20% of patients with genotype 2 or 3. Several approaches are now underway to prevent or ameliorate mechanisms of disease progression. In Asia, and particularly in Japan, Glycyrrhizine-SNMC has been widely used for this purpose. At present, SNMC is under clinical evaluation in Europe.
This book, the proceedings of the Falk Workshop on 'Prevention of Progression in Chronic Liver Disease - An Update on SNMC (Stronger Neo-Minophagen C)' (Part IV of the XII Falk Liver Week, in honour of Hans Popper's 100th birthday) held in Freiburg, Germany, on 22 October 2003, is devoted to the understanding of basic mechanisms of fibrogenesis, the state of the art of non-invasive markers of disease progression that may substitute liver biopsy in the future, and of other predictive parameters indicating disease progression, in particular the development of hepatocellular carcinoma. All these problems are particularly relevant for chronic hepatitis C. A better characterization of so-called non-responders for the treatments available is crucial for the development of new strategies preventing or postponing disease progression. Such strategies should influence fibrogenesis and, thus, cirrhosis formation as well as the development of life threatening complications of liver cirrhosis, including hepatocellular carcinoma. In this volume, the available information on SNMC as an approach to prevent progression of chronic liver disease is discussed by several internationally renowned authors who report on the mechanisms of liver fibrogenesis and fibrolysis, on non-invasive markers of disease progression, and on hepatocellular carcinoma as one of the major complications of liver cirrhosis nowadays. Finally, experts from Japan report on their knowledge and experience concerning the drug SNMC/Glycyrrhizine in the prevention of cirrhosis and HCC, and first study results from Europe are presented.