Pentoxifylline in the management of metabolic syndrome and chronic hepatitis C

Abstract

Metabolic syndrome (MS) and chronic hepatitis C (CHC) are prevalent diseases with many serious and fatal outcomes. Many of these outcomes are attributed to increased level of TNF-α which causes insulin resistance (IR), liver damage, increased incidence and mortality of hepatorenal syndrome (HRS), liver fibrosis and nonalcoholic steatohepatitis (NASH). So, an approach that depends on reducing the TNF-α levels is considered a reasonable method to help treat these conditions. Putting together the available data in the previous literature about pentoxifylline (PTX) would highly suggest that this drug is perfect for managing these conditions. Through its inhibitory effect on the production of TNF-α, it would improve the IR state and improve MS. It would also improve the liver condition in NASH which is associated with IR. And by its effect on enhancing the blood flow and decreasing its viscosity, it could also have a protective role against the cardiovascular incidents that develop with IR and MS. In CHC, it would decrease the IR that is associated with HCV infection and this would subsequently increase the response to the antiviral therapy and reduce the liver damage. It was also proven to decrease the incidence and mortality of HRS that develops in cirrhosis. PTX also has anti-fibrotic effects which can stop the liver fibrosis. The PTX effect should be evaluated experimentally and by clinical trials on patients as it can be a breakthrough in the management of MS and CHC. Such an affordable drug would remarkably decrease the expense of the management of these conditions, and would reduce the morbidity and mortality in those patients, which would indirectly increase the productivity in the societies that have a high prevalence of these diseases.