Early hepatoprotection with SAMe in patients with chronic liver disease
DOI:
https://doi.org/10.18203/2320-6012.ijrms20251016Keywords:
Ademetionine, Chronic liver diseases, Hepatoprotective agent, Liver enzymes, Super nutrient, S-adenosyl-L-methionineAbstract
S-adenosyl-L-methionine (SAMe) plays a crucial role in liver health by influencing various biochemical pathways involved in hepatic function. Early intervention with SAMe has been shown to reduce the progression rate of cirrhosis. A comprehensive literature search was performed to identify studies highlighting the benefits of early treatment with SAMe in conditions such as intrahepatic cholestasis (IHC), intrahepatic cholestasis of pregnancy (ICP), viral hepatitis, drug-induced liver injury (DILI), alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), hepatocellular carcinoma (HCC) and chemotherapy-induced liver injury (CILI). The mechanism of action of SAMe and its associated pathways were also detailed. Significant improvements in liver enzymes such as AST, ALT, GGT and ALP have been reported in the literature with treatment durations as short as 2 weeks. Reduction in symptoms such as pruritus, fatigue and jaundice has also been observed. The data suggest that SAMe has beneficial effects on liver biochemistry and clinical symptoms. It can act as an important clinical asset in the management of liver conditions alongside etiology-specific management. Further studies can be done to evaluate the benefits of SAMe as a hepatoprotective agent for the early treatment of liver dysfunction.
Metrics
References
Madrigal-Santillán E, Madrigal-Bujaidar E, Álvarez-González I, Sumaya-Martínez MT, Gutiérrez-Salinas J, Bautista M, et al. Review of natural products with hepatoprotective effects. World J Gastroenterol. 2014;20(40):14787-804. DOI: https://doi.org/10.3748/wjg.v20.i40.14787
Nipanikar SU, Chitlange SS, Nagore D. Pharmacological evaluation of hepatoprotective activity of AHPL/AYTAB/0613 tablet in carbon tetrachloride-, ethanol- and paracetamol-induced hepatotoxicity models in Wistar albino rats. Pharmacognosy Res. 2017;9(1):41-7. DOI: https://doi.org/10.4103/pr.pr_44_17
Anstee QM, Day CP. S-adenosylmethionine (SAMe) therapy in liver disease: a review of current evidence and clinical utility. J of Hepatol. 2012;57(5):1097-109. DOI: https://doi.org/10.1016/j.jhep.2012.04.041
Lieber CS. S-adenosyl-L-methionine: its role in the treatment of liver disorders. The American J of Clin Nutr. 2002;76(5):1183-7. DOI: https://doi.org/10.1093/ajcn/76.5.1183S
Guo T, Chang L, Xiao Y, Liu Q. S-adenosyl-L-methionine for the treatment of chronic liver disease: a systematic review and meta-analysis. PloS one. 2015;10(3):122124-6. DOI: https://doi.org/10.1371/journal.pone.0122124
Saigal S, Kapoor D, Roy D Sen. Ademetionine in patients with liver disease: a review. Int J Res Med Sci. 2019;7(6):2482–93. DOI: https://doi.org/10.18203/2320-6012.ijrms20192550
Lu SC, Mato JM. S-adenosylmethionine in liver health, injury and cancer. Physiol rev. 2012;92(4):1515-42. DOI: https://doi.org/10.1152/physrev.00047.2011
Medici V, Virata MC, Peerson JM, Stabler SP, French SW, Gregory III JF, et al. S‐adenosyl‐L‐methionine treatment for alcoholic liver disease: a double‐blinded, randomized, placebo‐controlled trial. Alcoholism: Clin Experim Res. 2011;35(11):1960-S5. DOI: https://doi.org/10.1111/j.1530-0277.2011.01547.x
Frazier TH, Stocker AM, Kershner NA, Marsano LS, McClain CJ. Treatment of alcoholic liver disease. Therap Adv Gastroenterol. 2011;4(1):63-81. DOI: https://doi.org/10.1177/1756283X10378925
Mato JM, Lu SC. Role of S‐adenosyl‐L‐methionine in liver health and injury. Hepatology. 2007;45(5):1306-12. DOI: https://doi.org/10.1002/hep.21650
Frezza M, Surrenti C, Manzillo G, Fiaccadori F, Bortolini M, Di Padova C. Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis: a double-blind, placebo-controlled study. Gastroenterol. 1990;99(1):211-5. DOI: https://doi.org/10.1016/0016-5085(90)91250-A
Virukalpattigopalratnam MP, Singh T, Ravishankar AC. Heptral (ademetionine) in patients with intrahepatic cholestasis in chronic liver disease due to non-alcoholic liver disease: results of a multicentre observational study in India. J of the Indian Med Association. 2013;111(12):856-9.
Ivashkin VT, Maevskaya MV, Kobalava ZD, Uspenskiy YP, Fominih JA, Rozanov AV, et al. Open-label study of ademetionine for the treatment of intrahepatic cholestasis associated with alcoholic liver disease. Minerva Gastroenterol Dietol. 2018;64(3):208-19. DOI: https://doi.org/10.23736/S1121-421X.18.02461-3
Binder T, Salaj P, Zima T, Vitek L. Randomized prospective comparative study of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of intrahepatic cholestasis of pregnancy. J Perinat Med. 2006;34(5):383-91. DOI: https://doi.org/10.1515/JPM.2006.077
Feld JJ, Modi AA, El–Diwany R, Rotman Y, Thomas E, Ahlenstiel G, et al. S-adenosyl methionine improves early viral responses and interferon-stimulated gene induction in hepatitis C nonresponders. Gastroenterol. 2011;140(3):830-9. DOI: https://doi.org/10.1053/j.gastro.2010.09.010
Perlamutrov Y, Bakulev A, Korsunskaya I, Orlov E, Bolotnikova N. Ademetionine in treatment of drug induced liver injury: an observational study in Russian patients, receiving immunosuppressive therapy for psoriasis. Int J Pharm Sci Res. 2014;5(12):5163-9.
Choudhuri G, Singh T. Heptral®(Ademetionine) in patients with chronic alcoholic liver disease: Results of a multicentre observational study in Indian patients. Int J Res Health Sci. 2014;2(3):831-41.
Boming L. Observation of efficacy of ademetionine for treating non-alcoholic fatty liver disease. Chin J Hepatol. 2011;16(4):350-1.
MA L. Observation of efficacy of treating non-alcoholic steatohepatitis by S-adenosyl-methionine. Chinese Hepatol. 2011;16(5):45.
Antoniv A, Antofiychuk N, Danylyshina T, Trefanenko I, Shuper V. Clinical efficacy of s-adenosylmethionine in patients with non-alcoholic steatohepatitis and chronic kidney disease i-ii stage. Georgian Med News. 2017;1(273):31-6.
Santini D, Vincenzi B, Massacesi C, Picardi A, Gentilucci UV, Esposito V, et al. S-adenosylmethionine (AdoMet) supplementation for treatment of chemotherapy-induced liver injury. Anticancer Res. 2003;23(6):5173-9.
Ansorena E, Garcıa-Trevijano ER, Martınez-Chantar ML, Huang ZZ, Chen L, Mato JM, et al. S-adenosylmethionine and methylthioadenosine are antiapoptotic in cultured rat hepatocytes but proapoptotic in human hepatoma cells. Hepatology. 2002;35(2):274-80. DOI: https://doi.org/10.1053/jhep.2002.30419
Ramani K, Yang H, Xia M, Ara AI, Mato JM, Lu SC. Leptin's mitogenic effect in human liver cancer cells requires induction of both methionine adenosyltransferase 2A and 2β. Hepatology. 2008;47(2):521-31. DOI: https://doi.org/10.1002/hep.22064
Mora SI, García-Román J, Gómez-Ñañez I, García-Román R. Chronic liver diseases and the potential use of S-adenosyl-L-methionine as a hepatoprotector. European J of Gastroenterol & Hepatol. 2018;30(8):893-900. DOI: https://doi.org/10.1097/MEG.0000000000001141
Noureddin M, Sander-Struckmeier S, Mato JM. Early treatment efficacy of S-adenosylmethionine in patients with intrahepatic cholestasis: A systematic review. World J Hepatol. 2020;12(2):46-63. DOI: https://doi.org/10.4254/wjh.v12.i2.46
Hall P, Cash J. What is the real function of the liver ‘function’tests? Ulster Med J. 2012;81(1):30-6.
Wood AM, Livingston EG, Hughes BL, Kuller JA. Intrahepatic cholestasis of pregnancy: a review of diagnosis and management. Obstet Gynecol Surv. 2018;73(2):103-9. DOI: https://doi.org/10.1097/OGX.0000000000000524
Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014;1;124(1):120-33. DOI: https://doi.org/10.1097/AOG.0000000000000346
Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy: recent advances. Clin Dermatol. 2016;1;34(3):327-34. DOI: https://doi.org/10.1016/j.clindermatol.2016.02.004
Zhang Y, Lu L, Victor DW, Xin Y, Xuan S. Ursodeoxycholic Acid and S-adenosylmethionine for the Treatment of Intrahepatic Cholestasis of Pregnancy: A Meta-analysis. Hepat Mon. 2016;16(8):38558. DOI: https://doi.org/10.5812/hepatmon.38558
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence and outcomes. Hepatology. 2016;64(1):73-84. DOI: https://doi.org/10.1002/hep.28431
Shalimar, Elhence A, Bansal B, Gupta H, Anand A, Singh TP, et al. Prevalence of Non-alcoholic Fatty Liver Disease in India: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2022;12(3):818-29. DOI: https://doi.org/10.1016/j.jceh.2021.11.010
Noureddin M, Mato JM, Lu SC. Nonalcoholic fatty liver disease: update on pathogenesis, diagnosis, treatment and the role of S-adenosylmethionine. Exp Biol Med (Maywood). 2015;240(6):809-20. DOI: https://doi.org/10.1177/1535370215579161
Amin KA, Hashem KS, Al-muzafar HM, Taha EM. Oxidative hepatotoxicity effects of monocrotaline and its amelioration by lipoic acid, S-adenosyl methionine and vitamin E. J Complement Integr Med. 2014;11(1):35-41. DOI: https://doi.org/10.1515/jcim-2013-0041
Vincenzi B, Russo A, Terenzio A, Galvano A, Santini D, Vorini F, et al. The use of SAMe in chemotherapy-induced liver injury. Crit Rev Oncol Hematol. 2018;130:70-7. DOI: https://doi.org/10.1016/j.critrevonc.2018.06.019
Lu SC, Ramani K, Ou X, Lin M, Yu V, Ko K, et al. S‐adenosylmethionine in the chemoprevention and treatment of hepatocellular carcinoma in a rat model. Hepatology. 2009;50(2):462-71. DOI: https://doi.org/10.1002/hep.22990
Li TW, Peng H, Yang H, Kurniawidjaja S, Panthaki P, Zheng Y, et al. S-Adenosylmethionine and methylthioadenosine inhibit β-catenin signaling by multiple mechanisms in liver and colon cancer. Mol Pharmacol. 2015;87(1):77-86. DOI: https://doi.org/10.1124/mol.114.095679
Zhang N, Wei P, Gong A, Chiu WT, Lee HT, Colman H, et al. FoxM1 promotes β-catenin nuclear localization and controls Wnt target-gene expression and glioma tumorigenesis. Cancer Cell. 2011;20(4):427-42. DOI: https://doi.org/10.1016/j.ccr.2011.08.016
Lyon GM, Porter FS. S-Adenosyl-L-methionine in a Neuroblastoma. Pediatr Res. 1970;4(5):454-5. DOI: https://doi.org/10.1203/00006450-197009000-00082
Schaller JL, Thomas J, Bazzan AJ. SAMe use in children and adolescents. European Child & Adolescent Psychiatry. 2004;13(5):332-4. DOI: https://doi.org/10.1007/s00787-004-0396-9
Choi LJ, Huang JS. A pilot study of S-adenosylmethionine in treatment of functional abdominal pain in children. Altern Ther Health Med. 2013;19(5):61-4.
S-Adenosyl-L-Methionine (SAMe): In Depth. NCCI. Avaialble at: https://www.nccih.nih.gov. Accessed on 20 December 2024.
Downloads
Published
How to Cite
Issue
Section
