Trace element status and its role in the course of chronic hepatitis C (literature review)
DOI:
https://doi.org/10.24144/2415-8127.2020.62.73-79Keywords:
viral hepatitis C, antiviral therapy, trace elements, zinc.Abstract
Introduction. Chronic hepatitis C (CHC) is a serious problem of current medicine. In hepatic pathology, the distribution and metabolism of most trace elements (micrielements) is disrupted, and dyselementosis itself complicates the course of hepatitis. Aim. Summarize information of the microelements role in the course of chronic hepatitis C. Materials and methods. Content-analysis of the literature on studies of the concentration and biological role of trace elements in patients with CHC. Results. The information on the role of microelements in the course of CHC is generalized. The relevance of studying the biological role of zinc in the normal functioning of the liver, its antioxidant and anti-inflammatory properties, changes in concentration and metabolism in liver pathology. It is shown that the decrease in Zn levels is inversely correlated with the degree of liver damage and changes in biochemical parameters, as Zn deficiency can promote collagen production and activation of liver stellate cells. The ability of Zn to interact with Cu and Fe is noted, reducing their content in tissues and slowing down oxidation processes. It is mentioned that Zn deficiency causes dysregulation in the cytokine chain of the immune system, in particular the imbalance between the function of Th1 and Th2 in the periphery. The production of IFN-γ and IL-2, Th1 products, decreases, while the production of IL-4, IL-6 and IL-10 Th2 does not change. Possibilities of zinc use in antiviral therapy in patients with chronic hepatitis C and zinc deficiency to improve virological response and systemic immunity were analyzed. The role of zinc deficiency in the occurrence of hepatocellular carcinoma has been determined. Information on the role of selenium, copper and iron deficiency or excess in the life cycle of hepatitis C virus, tissue damage, liver fibrosis and their importance in response to treatment is summarized. The role of microelements in the course of CHC is analyzed and the importance of monitoring their concentration in the process of diagnosis and treatment is noted. Prospects for studying the trace element status in patients with CHC have been clarified to better understand the pathogenesis of the disease and improve treatment tactics. Conclusion. The analyzed research results complement the data on the role of trace elements Zn, Fe, Se, Cu in the course of chronic hepatitis C, and the possibility of using zinc as part of antiviral therapy in its deficiency.
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