Abstract
Background: Hepatic fibrosis is the major issue in chronic liver diseases such as chronic
hepatitis C virus (HCV). The newly approved direct acting antiviral (DAA) agents such as Sofosbuvir
(SOF) and daclatasvir (DAC) have been found to be associated with decreased fibrotic markers in
HCV patients.
Aim: This study tried to explore whether the reported antifibrotic effect of these drugs is antiviral dependent
or drug induced.
Method: Hepatic fibrosis was induced by (0.5ml/kg) CCl4 IP twice a week for six weeks. SOF (20
mg/kg/d) and DAC (30 mg/kg/d) were added in the last four weeks of treatments. Liver functions,
fibrotic markers such as Hyaluronic acid and metalloproteinase-9 were detected using immunoassay.
The expression of TNF-α/NF-κB signaling pathway as well as Bcl-2 were done using immunoassay.
Results: SOF and DAC exerted a potent antifibrotic effect evidenced by their activity against
hyaluronic acid HA and metalloproteinase MMP-9 significantly (P≤0.001). This effect was further
proved histopathologically where liver tissues from rats treated by drugs showed marked inhibition of
collagen precipitation as well as inhibition of HSCs activation. This antifibrotic action was associated
with decreased expression of TNF-α /NF-κB signaling pathway and induction of Bcl-2.
Conclusion: SOF/ DAC antifibrotic effect is independent of its antiviral activity. The molecular events
associated with this effect were the downregulation of TNF-α / NF-κB signaling pathway and induction
of Bcl-2.
Keywords:
Sofosbuvir, daclatasvir, TNF-α, NF-κB, hepatic fibrosis, Bcl-2.
Graphical Abstract
[2]
El-Zanaty, F.; Way, A. Egypt Demographic and Health Survey
2008.(Ministry of Health, El-Zanaty and Associates, and Macro International.):
Cairo, Egypt , 2009.
[3]
Ministry of Health and Population [Egypt], El-Zanaty and Associates
[Egypt] and ICF International. Egypt Health Issues Survey 2015.
(Cairo, Egypt and Rockville, Maryland, USA: Ministry of Health and
Population and ICF International, 2015)., , 2015.
[4]
WHO. Hepatitis C fact sheet no. 164 [updated July 2015], , 2016.
[16]
Ishikawa, T.; Imai, M.; Owaki, T.; Sato, H. Serum Wisteria floribunda Agglutinin Positive Mac-2-Binding Protein and Fib-4 Index on the Clinical Course of Patients with Chronic Hepatitis C Receiving Daclatasvir/Asunaprevir Therapy. Ann Digest Liver Dis., 2017, 1, 1001.
[23]
Banchroft, J.D.; Stevens, A.; Turner, D.R. Theory and practice of histological techniquesNew York; London, San Francisco, Tokyo: Churchil Livingstone, 1996.
[40]
Singal, A.G.; Rich, N.E.; Mehta, N.; Branch, A.; Pillai, A.; Hoteit, M.; Volk, M.; Odewole, M.; Scaglione, S.; Guy, J.; Said, A.; Feld, J.J.; John, B.V.; Frenette, C.; Mantry, P.; Rangnekar, A.S.; Oloruntoba, O.; Leise, M.; Jou, J.H.; Bhamidimarri, K.R.; Kulik, L.; Tran, T.; Samant, H.; Dhanasekaran, R.; Duarte-Rojo, A.; Salgia, R.; Eswaran, S.; Jalal, P.; Flores, A.; Satapathy, S.K.; Wong, R.; Huang, A.; Misra, S.; Schwartz, M.; Mitrani, R.; Nakka, S.; Noureddine, W.; Ho, C.; Konjeti, V.R.; Dao, A.; Nelson, K.; Delarosa, K.; Rahim, U.; Mavuram, M.; Xie, J.J.; Murphy, C.C.; Parikh, N.D. Direct-Acting Antiviral Therapy Not Associated With Recurrence of Hepatocellular Carcinoma in a Multicenter North American Cohort Study.
Gastroenterology, 2019,
156(6), 1683-1692.
[
http://dx.doi.org/10.1053/j.gastro.2019.01.027 ] [PMID:
30660729]