Amro chemical fiber provides a solution for reversing liver fibrosis

From April 20 to 23, 2023, the "2023 Xi 'an Conference on Digestive Liver Disease", sponsored by China Health Promotion Foundation and co-organized by National Clinical Medical Research Center for Digestive Diseases, Autoimmune Hepatology Group of Chinese Medical Association and Immune Hepatology Group of Shaanxi Medical Association, was held. The treatment prospect of liver disease in China was discussed.

The treatment of chronic liver disease includes etiology treatment, liver fibrosis and cirrhosis treatment, cirrhosis complications treatment and liver cancer monitoring. Liver fibrosis is the repair response after chronic liver injury, and the process of liver fibrosis cannot be completely inhibited after treatment for the cause of chronic liver disease, so it is very important to deal with liver fibrosis. In this meeting, under the leadership of Professor Nan Yuemin of the Third Hospital of Hebei Medical University, Professor Zhou Xinmin of Xijing Hospital of Air Force Military Medical University explained in depth the difficulties and countermeasures faced by the treatment of liver fibrosis after etiology control, and demonstrated the cutting-edge solution strategy brought by Anluo chemical fiber, a major scientific and technological project in China's "Twelfth Five-Year Plan" and "thirteenth Five-Year Plan".

Etiological treatment could not completely inhibit intrahepatic inflammation and fibrosis

Patients with chronic liver disease often develop liver fibrosis, cirrhosis and liver cancer because of the inflammatory response and hepatic stellate cell activation in the process of self-repair. In general, the cause of chronic liver disease is controlled or eliminated, which allows the liver to regenerate and repair itself, reversing fibrosis. However, clinical etiological treatment cannot completely inhibit the development of intrahepatic inflammation and fibrosis: for example, in the standard treatment of autoimmune cirrhosis (AIH) and primary biliary cirrhosis (PBC), the progression of fibrosis in patients with poor response is significantly higher than that in patients with poor response, and about 30% to 40% of PBC patients in the clinic have poor response to standard treatment. For patients with chronic hepatitis B (CHB), only 1/3~1/2 patients with liver fibrosis Ishak score improved after one year of single antiviral treatment, which is far from meeting clinical needs. Therefore, for patients with chronic liver disease who still have a progressive trend, only the treatment is not enough, and it is necessary to combine anti-fibrosis drugs.

Multi-target, multi-pathway anti-fibrosis mechanism of Anlo chemical fiber

Anluo chemical fiber has shown good results in anti-fibrosis in the national "Twelfth Five-Year Plan" and "thirteenth Five-Year Plan" major special project research, and has been approved by China's drug Administration for the treatment of chronic hepatitis B patients with early and mid-stage cirrhosis. The team of Academician Zhuang Hui and Professor Liu Xueen of Peking University Health Science Center revealed the specific mechanism of its action through basic research. Amro can significantly inhibit the production of transforming growth factor TGFβ1 and the influence of the corresponding Smads signaling pathway, thus inhibiting the activation of hepatic stellate cells (HSC). At the same time, it can promote the expression of protective hepatocyte factor PPARγ and inhibit the pro-fibrotic pathway NF-κB/IκBα. It can also enhance the expression of MMP-13 and inhibit the expression of MMP-2 and TIMP-1/2. Through the above-mentioned multi-target and multi-pathway mechanisms, Anluo chemical fiber plays an anti-fibrosis role and improves liver function, which provides a theoretical basis for a series of clinical studies and clinical applications.

The foundation was laid for the major projects of the 12th Five-Year Plan

The national "Twelfth Five-Year" major science and technology special project for the topic of Anluo chemical fiber was explored from the Western medicine group and the Chinese medicine group. In the Western medicine group, led by Professor Wang Guiqiang/Zhao Hong of Peking University First Hospital and Professor Jia Jidong/You Hong of Beijing Friendship Hospital, 25 units across the country participated in the study, exploring the establishment of non-invasive diagnostic criteria/models for HBV-related liver fibrosis, and exploring the reversal of hepatitis B fibrosis/cirrhosis by Anluo chemical fiber. In this randomized, open (pathologically blind), controlled, multicenter, prospective study of Entecavir (ETV) combined with ALHX to reverse the progression of liver fibrosis/cirrhosis: Seventy-six patients with F < 3 at baseline were included. The stabilization rate of ETV+ALHX combined group (55.32%) at 78 weeks was significantly higher than that of ETV monotherapy group (31.03%) by 24.29% (P=0.039). In addition, 143 patients with baseline F≥3 were included, and the 78-week treatment improvement rate in the ETV+ALHX combined group (54.74%) was significantly increased by 21.41% (P=0.016) compared with that in the ETV monotherapy group (33.33%). Based on this, an expanded sample size study was conducted for this patient group during the 13th Five-Year Plan period. This study suggests that amro combined with entecavir can significantly improve the improvement rate of liver fibrosis in hepatitis B virus infected patients, and has a tendency to improve the stability rate of liver fibrosis and reduce the progression rate.