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PERSPECTIVAS TERAPEUTICAS PARA EL TRATAMIENTO DE LA HEPATITIS C CRONICA

(especial para SIIC © Derechos reservados)
La mayoría de las nuevas moléculas analizadas en este artículo deberán ser estudiadas más a fondo, quizás asociadas con los interferones pegilados y la ribavirina, para determinar su valor real, especialmente en lo que respecta a criterios de valoración clínicos, como la respuesta viral sostenida y los puntajes de fibrosis hepática.
aspinall9.jpg Autor:
Richard Aspinall
Columnista Experto de SIIC

Institución:
Division of Gastroenterology/Hepatology, Scripps Clinic

Artículos publicados por Richard Aspinall
Coautor
Paul Pockros* 
MD, Scripps Clinic*
Recepción del artículo
30 de Diciembre, 2005 		Aprobación
13 de Enero, 2006
Primera edición
22 de Junio, 2006 		Segunda edición, ampliada y corregida
7 de Junio, 2021

PERSPECTIVAS TERAPEUTICAS PARA EL TRATAMIENTO DE LA HEPATITIS C CRONICA

Resumen
Los ensayos clínicos recientes mostraron que el tratamiento combinado con interferón pegilado y ribavirina puede lograr una respuesta viral sostenida en la mayoría de los pacientes con hepatitis C crónica que califiquen para dicha terapia. Sin embargo, debido a que muchos pacientes no pueden ser tratados (o escogen no serlo en virtud de los efectos colaterales), se hace muy necesario mejorar la eficacia y disminuir los efectos adversos de los fármacos empleados. Los nuevos fármacos recién diseñados ofrecen la ventaja de ser más selectivos y existen varias moléculas prometedoras en fases avanzadas de investigación. En este artículo se revisarán los descubrimientos más recientes que hacen al tratamiento inmunomodulador para la hepatitis C crónica, incluidas las interleuquinas, timosina, interferón gamma, moléculas semejantes al interferón, inhibidores de la inosina 5'-monofosfato deshidrogenasa, antagonistas del factor de necrosis tumoral, análogos de la ribavirina, inhibidores de la caspasa y las vacunas terapéuticas. Si bien algunos de estos compuestos no probaron ser eficaces, muchos se encuentran en las fases preliminares de investigación y se los considera agentes terapéuticos potencialmente efectivos.

Palabras clave
hepatitis C, inmunomoduladores, interleuquina, IMPDH, viramidina


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NOVEL IMMUNOMODULATORY THERAPIES FOR CHRONIC HEPATITIS C INFECTION

Abstract
Recent clinical trials have shown that combination therapy with pegylated interferon and ribavirin can achieve a sustained virological response in the majority of patients with chronic hepatitis C who qualify for treatment. However, because many patients are unable to be treated (or choose not to due to side effects), there remains a pressing need for improving efficacy and reducing adverse effects. Newer drugs emerging from the laboratory offer hopes of more rational drug targeting and there are several promising pharmaceuticals in the advanced stages of development. In this article we review recent developments in novel immunomodulatory therapies for chronic hepatitis C, including interleukins, thymosin, interferon gamma, oral-interferon-like molecules, IMPDH inhibitors, tumor necrosis factor antagonists, ribavirin analogues, caspase inhibitors and therapeutic vaccines. Although some of these compounds have failed to show benefit, many are still in the early stages of development and therefore hold out promise as potentially effective new therapies.

Key words
hepatitis C, immunomodulators, interleukin, IMPDH, viramidine


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Especialidades
Principal: Farmacología, Medicina Interna
Relacionadas: Gastroenterología, Infectología, Inmunología



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Enviar correspondencia a:
Paul Pockros, Division of Gastroenterology/Hepatology, Scripps Clinic, CA 92037, 10666 North Torrey Pines Road, La Jolla, EE.UU.
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