Combination Therapy with Vitamin D and Telmisartan to Suppress the Progression of Liver Fibrosis.

Abstract

Hepatic fibrosis is an improper wound repair response associated with various kinds of chronic liver injuries. It can be detected by over-deposition of diffuse ECM (Extracellular Matrix) and abnormal overgrowth of connective tissue, and it can progress to cirrhosis or hepatocellular carcinoma. Chronic liver diseases, which include liver fibrosis, have resulted in significant morbidity and mortality worldwide, and this trend is likely to continue. Although early liver fibrosis has been reported to be reversible, the exact mechanism of reversal is unidentified, and there is a lack of effective therapy for liver fibrosis. Vitamin D is essential for maintaining the metabolism of bone and calcium balance. Unexpectedly new evidence indicates that vitamin D has a protective function toward hepatic fibrosis. Telmisartan has been shown to have a positive effect on hepatic fibrosis markers in various pathological contexts. This review focused on summarizing the effect of vitamin D and telmisartan on the progression of hepatic fibrosis and updating their present impact on fibrosis. Telmisartan and vitamin D reduce fibrosis in hepatic stellate cells by inhibiting the production of profibrogenic genes.