Premium
Histopathologic changes in S‐adenosyl‐L‐methionine treated patients with alcoholic liver disease: an in‐depth look at data from a double‐blinded, randomized, placebo controlled trial
Author(s) -
Le Mary D,
Enbom Elena,
Traum Peter K,
Medici Valentina,
Halsted Charles H,
French Samuel W
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.lb442
Subject(s) - medicine , placebo , stain , liver biopsy , biopsy , gastroenterology , alcoholic liver disease , randomized controlled trial , liver disease , concomitant , pathology , surgery , cirrhosis , staining , alternative medicine
Objective The objective of this study is to assess if there were any changes in liver biopsies after treatment with S‐adenosyl‐L‐methionine (SAMe) in alcoholic liver disease patients. Design Liver biopsies of 14 patients were randomized for SAMe treatment at week 0 (biopsy #1) and at 24 weeks (biopsy #2). Patients received 1.2 g of SAMe or placebo by mouth daily and stopped alcohol intake. Biopsies were semi‐quantitatively scored for: necrosis, tunnel formation, smooth muscle actin, kupffer cells, polymorphonuclear leukocytes, lipogranules, lymphocytes, balloon cell formation, and duct metaplasia. Results Comparing treatment arm to placebo arm, no significant difference was found between biopsy #1 and biopsy #2. However, when both study arms were grouped together, there was decrease in smooth muscle actin stain, where the p‐value=0.027. Conclusion Treatment with SAMe did not show a statistically significant difference in the characteristics studied. However, when both the treatment and placebo arm data were grouped together to increase the n and power, there was a decrease in the smooth muscle actin stain, reflecting a decrease in stellate cells activation, likely due to the alcohol abstinence. This study shows that it may not be beneficial to wait for more definitive treatment, like liver transplant, because the liver tissue will remain with the same degree of pathology six months out, regardless.