Keywords
Chronic hepatitis B
Hemoglobin
Protoporphyrin
Porphyrin
Submitted : 2022-04-30
Accepted : 2022-05-15
Published : 2022-05-30
Abstract
Liver cirrhosis is an important cause of chronic liver cancer. At present, a breakthrough has been achieved in the development of chronic hepatitis C treatment, but there is no effective measure to completely cure chronic hepatitis B. Porphyrins are a class of macromolecular heterocyclic compounds formed by interconnecting the ?-carbon atoms of four pyrrole-like substituents through hypomethyl bonds. Porphyrins and their derivatives widely exist in organelles related to energy transfer in organisms. They are mainly involved in the synthesis of heme in human body. Heme is an iron-containing porphyrin compound, 15–20% of which is synthesized and utilized in the liver. Studies have found that porphyrin metabolism disorder can occur in patients with chronic liver disease. The early stage of viral hepatitis is accompanied by increased production of porphyrins and their compounds, increased levels of peripheral circulating porphyrins, porphyrin cholestasis, and biochemical changes of free porphyrins which precede the histological changes. The accumulation of serum and liver protoporphyrins and the oxidative stress can cause liver and extrahepatic damage. On the one hand, porphyrin metabolism disorder can aggravate chronic liver disease, and even progress to liver cirrhosis and liver cancer. On the other hand, chronic liver disease can also aggravate porphyrin metabolism disorder, recurrent attacks, and damage to liver and extrahepatic tissues and organs.
References
Zhao H, 2019, Antiviral Treatment and Indications for Patients with Chronic Hepatitis B Virus Infection: Interpretation of Guidelines for The Prevention and Treatment of Chronic Hepatitis B (2019 Edition). International Journal of Epidemiology and Infectious Diseases, 2019(06): 466-470.
2020, Guidelines for Prevention and Treatment of Hepatitis C (2019 Edition). Chinese Journal of Infectious Diseases, 2020(01): 9-28.
Wei L, 2014, Impact of New Hepatitis C Treatments in Different Regions of the World. Gastroenterology, 146(5): 1145-1150.
Fan J, Zeng J, 2020, Epidemic Status and Harm of Nonalcoholic Liver Disease.Chinese Journal of Digestion, 40(09): 577-580.
Yun-Fan L, 2009, Natural History of Chronic Hepatitis B Virus Infection and Long-Term Outcome Under Treatment. Liver Int, 29(Suppl 1): 100-107.
Fanning GC, Zoulim F, Hou J, et al., 2019, Therapeutic Strategies for Hepatitis B Virus Infection: Towards a Cure. Nat Rev Drug Discov, 18(11): 827-844.
Chee-Kin H, Nancy L, Siu-Tsan Y, et al., 2007, Natural History and Disease Progression in Chinese Chronic Hepatitis B Patients in Immune-Tolerant Phase. Hepatology (Baltimore, Md.), 46(2): 395-401.
Wang L, Huang X, Li Y, et al., 2009, Observation of Antiviral Efficacy of 102 Patients with Hepatitis B in “Immune Tolerance Period”. Ningxia Medical Journal, 31(12): 1176-1177.
Bonkovsky Herbert L, Jun-Tao G, Weihong H, et al., 2013, Porphyrin and Heme Metabolism and the Porphyrias. Comprehensive Physiology, 3(1): 365-401.
2020, Consensus of Chinese Experts on Diagnosis and Treatment of Porphyria (2020). Chinese Journal of Medicine, 2020(14): 1051-1056.
Liu X, Li S, Gao S, et al., 1992, Preliminary Study on the Changes of Hematoporphyrin in Patients with Chronic Liver Disease. Journal of Harbin Medical University, 1992(02): 99-101.
Bonkovsky HL, Dixon N, Rudnick S, 2019, Pathogenesis and Clinical Features of the Acute Hepatic Porphyrias (AHPs). Mol Genet Metab, 128(3): 213-218.
Antonio F, Ávila Matías A, Pedro B, 2016, Emerging Therapies for Acute Intermittent Porphyria. Expert Rev Mol Med, 18: e17.
Thunell S, 2016, The Attack of Acute Porphyria. Lakartidningen, 113: DXML.
To-Figueras J, 2019, Association Between Hepatitis C Virus and Porphyria Cutanea Tarda. Mol Genet Metab, 128(3): 282-287.
Krivosheev AB, Kondratova MA, Krivosheev BN, et al. 2011, Comparative Characteristics of Porphyrins Metabolism in Chronic Viral Diseases of the Liver. Ter Arkh, 83(2): 40-47.
Baravelli CM, Sandberg S, Aarsand AK, et al., 2019, Porphyria Cutanea Tarda Increases Risk of Hepatocellular Carcinoma and Premature Death: A Nationwide Cohort Study. BioMed Central, 14(1): 7.
Hanife UA, Feray A, 2019, Porphyria Cutanea Tarda: A Case Report. J Med Case Rep, 13(1): 17.
To-Figueras J, 2019, Association Between Hepatitis C Virus and Porphyria Cutanea Tarda. Mol Genet Metab, 128(3): 282-287.
Nakano T, Moriya K, Koike K, et al., 2018, Hepatitis C Virus Core Protein Triggers Abnormal Porphyrin Metabolism in Human Hepatocellular Carcinoma Cells. PLoS One, 13(6): e0198345.
Balwani M, 2019, Erythropoietic Protoporphyria and X-Linked Protoporphyria: Pathophysiology, Genetics, Clinical Manifestations, and Management. Mol Genet Metab, 128(3): 298-303.
Linenberger M, Fertrin KY, 2020, Updates on the Diagnosis and Management of the Most Common Hereditary Porphyrias: AIP and EPP. Hematology Am Soc Hematol Educ Program, 2020(1): 400-410.
Balwani M, Naik H, Anderson KE, et al., 2017, Clinical, Biochemical, and Genetic Characterization of North American Patients with Erythropoietic Protoporphyria and X-linked Protoporphyria. JAMA Dermatol, 153(8): 789-796.
Holme SA, Anstey AV, Finlay AY, et al., 2006, Erythropoietic Protoporphyria in the U.K.: Clinical Features and Effect on Quality of Life. Br J Dermatol, 155(3): 574-581.
Faut M, Paiz A, San Martín de Viale LC, et al., 2013, Alterations of the Redox State, Pentose Pathway and Glutathione Metabolism in an Acute Porphyria Model: Their Impact on Heme Pathway. Exp Biol Med (Maywood), 238(2): 133-143.
Casanova-González MJ, Trapero-Marugán M, Jones EA, et al., 2010, Liver Disease and Erythropoietic Protoporphyria: A Concise Review. World J Gastroenterol, 16(36): 4526-4531.
Singal AK, 2019, Porphyria Cutanea Tarda: Recent Update. Mol Genet Metab, 128(3): 271-281.
Agarwal S, Simon AR, Goel V, et al., 2020, Pharmacokinetics and Pharmacodynamics of the Small Interfering Ribonucleic Acid, Givosiran, in Patients with Acute Hepatic Porphyria. Clin Pharmacol Ther, 108(1): 63-72.
Bustos J, Vargas L, Quintero R, 2020, Acute Intermittent Porphyria: A Case Report. Biomedica, 40(1): 14-19.
Salley TN, Mishra M, Tiwari S, et al., 2013, The Heme Oxygenase System Rescues Hepatic Deterioration in the Condition of Obesity Comorbid with Type 2 Diabetes. PLoS One, 8(11): e79270.
Yang H, Zhang L, Zhang XQ, et al., 2018, Hemin Regulates the Expression of Nuclear Factor Kappa B of Heme Oxygenase-1 in Hepatic Fibrosis. Zhonghua Gan Zang Bing Za Zhi, 26(9): 654-659.
Schmitt C, Lenglet H, Yu A, et al., 2018, Recurrent Attacks of Acute Hepatic Porphyria: Major Role of the Chronic Inflammatory Response in the Liver. J Intern Med, 284(1): 78-91.
Anderson KE, 2019, Acute Hepatic Porphyrias: Current Diagnosis & Management. Mol Genet Metab, 128(3): 219-227.
Arora S, Young S, Kodali S, et al., 2016, Hepatic Porphyria: A Narrative Review. Indian J Gastroenterol, 35(6): 405-418.