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Copyright ©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Mar 14, 2014; 20(10): 2515-2532
Published online Mar 14, 2014. doi: 10.3748/wjg.v20.i10.2515
Table 2 Promising anti-fibrotic agents in chronic liver disease
Anti-fibrotic agentPossible anti-fibrotic actionsClinical experiences
Anti-oxidants
-acetylcysteineInhibits NF-κB activity[195]Limits pro-inflammatory genes[195]Reduces iNOS and NO activity[196]Decreases hepatocyte apoptosis[195]Reduced hepatic fibrosis and inflammation in NASH[191]
S-adenosyl-L- methionine (SAMe)Increase mitochondrial glutathione[197]Inhibit NF-κB activity[197]Reduce ROS production[197]Impair iNOS and NO production[197]Limit HSC activation[197]Decreased mortality and LT in alcoholic cirrhosis[190]Hastened decline of viral load and increased early response in HCV non-responders[192]
Vitamin EReduce TGF-β in animals and humans[199,200]Decrease oxidant stress on hepatocytes[198]Limit collagen deposition[198]Decreased hepatic fibrosis in NAFLD[201]Prevented progressive hepatic fibrosis in NAFLD[202]
Angiotensin inhibitors
LosartinLimit angiotensin II production by HSC[208]Decrease expression of pro-fibrotic genes[170]Limit NADPH-oxidase and oxidative stress[170]Reduce TGF-β and pro-collagen production[214]Decrease extracellular matrix[210,212,213]Small trial in chronic hepatitis C[170]Impeded pro-fibrotic and NADPH oxidase genes[170]Reduced oxidative stress[170]Decreased inflammatory and fibrosis scores in 50%[170]