A new word for hope!

http://www.timesonline.co.uk/article/0,,2087-2372358.html

The Sunday Times September 24, 2006


Drug may heal livers of chronic alcoholics
Sarah-Kate Templeton, Health Correspondent

BRITISH scientists have discovered a drug that could cure liver disease, even in alcoholics who continue drinking.

The medicine, found by a team of doctors and scientists at Newcastle University, could become a potential alternative to liver transplants.

Until now cirrhosis of the liver, caused by alcohol, obesity or the hepatitis C virus, was considered incurable in all but the rarest of cases. The only option for patients in the final stages of liver disease was to wait for a liver transplant. However, because of organ shortages many die while on the waiting list.

Clinical trials of the drug Sulphasalazine are expected to begin in Britain next year. If these prove successful, the drug could be used to treat heavy drinkers, whose plight was recently illustrated by George Best, the former Manchester United footballer who died from liver disease last year.

Sulphasalazine, which already has a licence to treat arthritis and inflammatory bowel disease, acts by preventing scarring from developing on the liver.

Tests carried out in the laboratory and on animals have shown that the medication can even reverse damage already inflicted on the liver.

The drug will initially be given to heavy drinkers who have given up alcohol, but too late for their liver to recover naturally. If this proves successful, the medicine will also be prescribed to alcoholics who continue to drink but show a determination to fight their addiction by reducing their intake.

Professor Christopher Day, who heads Britain’s biggest team of liver specialists at Newcastle University, said: “If you stop a drinker with cirrhosis of the liver from drinking, the cirrhosis will still be there. Even though we remove the cause of the liver scarring, by this stage that is not enough.

“The prospect is that you may be able to continue drinking. If the drug is not too expensive, I may say, of course we have to give these patients advice about drinking, but who are we to say, ‘Just because you are still drinking, we are not going to give you this drug’? I would be of the view that it should be tried in patients who are making an effort.

“I would not give it to someone who continues to drink heavily every day, but if someone had cut down to three pints a night and was really trying, why not give him this drug that might help his liver recover?”

Sulphasalazine may also relieve the ethical dilemmas of distributing scarce donated livers to the most needy and deserving. The decision to give Best a liver transplant was controversial because the late footballer continued drinking. Critics argued that the organ should have been given to someone whose illness was not self-inflicted.

If the drug is not prohibitively expensive, it could be given to all liver disease patients, regardless of whether the damage had been caused by a congenital disorder or years of alcohol abuse.

“This drug is not a finite resource, you are not stealing it from someone else — which is always a worry in public opinion. People are dying on the transplant list,” Day added.

After years of heavy drinking or obesity, so many scars appear on the liver that it can no longer carry out its normal tasks such as storing essential proteins and vitamins while cleaning up toxic substances.

The new use for the drug followed the discovery by Professor Derek Mann, a member of the team at Newcastle University, who identified the cells and proteins that may move the liver disease into reverse.

Mann found that when the liver is injured by a substance such as alcohol, proteins called nuclear factor kappa B encourage particular cells to multiply, which scars the organ. By switching off the nuclear factor kappa B protein, the scarring cells die and stop damaging the liver.

There are 45,000 deaths every year in Europe from cirrhosis of the liver but the number is decreasing.

In Britain, by contrast, where more than 4,000 die every year, the number of deaths from cirrhosis is increasing amid growing concern about the country’s so-called binge-drinking culture.

Doctors report that increasing numbers of young people, including women, are succumbing to liver disease caused by heavy drinking and poor diet.

Between 5% and 10% of people in the UK are unaware of having liver disease, which can be diagnosed by simple blood tests. Help is often sought when the symptoms become severe, which is too late for treatment.

Reseach spend per life lost for liver disease is amongst the lowest for all conditions — only respiratory medicine ranks lower.


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