Autoimmune Hepatitis, Toxic Hepatitis, Hepatitis B, Hepatitis C
Wobenzym in complex
therapy of chronic liver diseases
Vasilenko A. M., Svec S. V. Wobenzym in complex
therapy of chronic liver diseases. State Medical Academy in
Dnepropetrovsk. II National Congress of Rheumatologists in the
Ukraine, Kiev, 1997
Current complex therapy of chronic liver diseases focuses on
elimination of basic pathogenetic syndroms of the disease.
Glucocorticoids (GC) are the most effective in the treatment of
chronic autoimmune hepatitis (CAH) and active liver cirrhosis (LC)
with a significant autoimmune process. They appear to be effective
regulators of immune reaction which suppress antibody production.
One of the undesirable side-effects of GC is formation of
circulating middle size immune complexes (CIC) which intensify
cytolytic syndrom ( 1, 2, 4). One of the main characteristics of CIC
- pathogenesity - is mainly determined by the size of complexes.
Pathogenesity is caused, among others factors, also by a
quantitative relation between antigen and antibody. During
overproduction of antibodies against any antigen or in the case of
equivalent relation when antigen is fully or partially bound, large
CIC are formed. Mild excess of antigen over appropriate antibody
(ratio 3:2) leads to a formation of middle sized immune complexes.
Insufficient antibody production causes a formation of low molecular
weight complexes. Literature data (l, 2, 4) show that cytolysis is
higher when middle size CIC prevail. Optimal conditions for middle
size CIC formation arise in 2nd - 3rd week of the treatment by big
doses of GC. Wide use of GC is limited also by risk of possible
side-effects: pathological changes in organs of digestive system and
kidney, insufficient anti-inflammatory effect, impossible induction
of remission of the disease. All above mentioned facts speak for a
necessity to search for new methods to treat chronic liver diseases.
Systemic enzyme therapy seems to be one of the prospective options.