JCO：H1-抗组胺药可降低HBV、HCV或HBV-HCV合并感染患者患肝细胞癌的风险

2022-02-07 国际肝病国际肝病

在HBV、HCV或HBV-HCV合并感染患者中，AH的使用可能以剂量依赖性方式降低HCC的风险。

组胺是一种生物活性物质，可增强机体的炎症和免疫反应，并作为神经递质发挥作用[1,2]。抗组胺药（AHs）是通过阻断或抑制受体（H受体）来拮抗这些作用的药物[3]。根据靶向H受体的类型，它们被分类为H1或H2 AHs。H1-AHs主要用于治疗过敏反应和肥大细胞介导的疾病，它们是世界范围内治疗过敏症状（如缓解花粉热）最常用的药物之一。不过有研究显示H1-AHs可能对癌症具有保护作用[4]。近期，我国台湾Shen等人在Journal of Clinical Oncology上发表了一项研究，该研究调查了HBV、HCV或HBV-HCV合并感染患者使用AH与肝细胞癌（HCC）风险的相关性[4]。

该研究纳入了2006年1月1日至2015年12月31日接受检查的我国台湾地区居民健康保险研究数据库中的HBV、HCV或HBV-HCV合并感染患者，同时使用Kaplan-Meier方法和Cox比例风险回归评估AH与HCC风险之间的相关性。

结果该研究共纳入了521071例HBV感染患者、169159例HCV感染患者和39016例HBV-HCV合并感染患者。与未使用AHs的患者相比，使用AHs的HBV、HCV或合并感染患者的HCC风险显著降低，其调整后的危险比分别为0.489（95%CI：0.455~0.524）、0.484（95%CI：0.450~0.522）和0.469（95%CI：0.416~0.529）。此外，在HBV队列中，AH与HCC风险之间存在剂量反应关系。与未使用AHs相比，使用28-42、43-63、64-119和≥120的累积限定日剂量（defined daily dose，DDD）的AHs的校正危险比分别为0.597（95%CI：0.530~0.674）、0.528（0.465~0.600）、0.470（0.416~0.531）和0.407（0.362~0.457）。此外，在HCV和HBV-HCV合并感染队列中，AH与HCC风险之间也存在剂量反应关系。

图1. HCC累积发病率与AH的cDDD相关

（A）HBV队列，（B）HBV队列中的cDDD组，（C）HCV队列，（D）HCV队列中的cDDD组，（E）HBV-HCV合并感染队列，以及（F）HBV-HCV合并感染队列中的cDDD组。
cDDD，累积限定日剂量（defined daily dose，DDD）

综上所述，在HBV、HCV或HBV-HCV合并感染患者中，AH的使用可能以剂量依赖性方式降低HCC的风险。不过还需要进行进一步的机理研究。

参考文献

1.Branco ACCC, Yoshikawa FSY, Pietrobon AJ, et al. Role of Histamine in Modulating the Immune Response and Inflammation. Mediators Inflamm, 2018, 2018: 9524075.

2.Nuutinen S, Panula P. Histamine in neurotransmission and brain diseases. Adv Exp Med Biol, 2010, 709: 95-107.

3.Faustino-Rocha AI, Ferreira R, Gama A, et al. Antihistamines as promising drugs in cancer therapy. Life Sci, 2017, 172: 27-41.

4.Shen YC, Hsu HC, Lin TM, et al. H1-Antihistamines Reduce the Risk of Hepatocellular Carcinoma in Patients With Hepatitis B Virus, Hepatitis C Virus, or Dual Hepatitis B Virus-Hepatitis C Virus Infection. J Clin Oncol, 2022 Jan 19: JCO2101802.

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2022-05-11 xjy02

#肝细胞#

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2023-01-04 qingting

#细胞癌#

47 0
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2022-05-12 bluefate133

#组胺#

46 0
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2022-02-16 klivis

#HBV#

52 0
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2022-11-04 lidong40

#JCO#

35 0
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2022-02-09 ymljack

#HCV#

48 0
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2022-02-09 charl1234567

#抗组胺药#

43 0
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2022-02-08 ms4000000935962202

学习了

48 0
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2022-02-08 ms3000000637975859

普及面广

53 0

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JCO：H1-抗组胺药可降低HBV、HCV或HBV-HCV合并感染患者患肝细胞癌的风险

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