This citation references a study which showed a reversal of hepatic fibrosis in RATS treated with Sulfa! There are some VERY important physiological differences between rats and human toxin derived liver disease. The primary difference for unknown reasons the rodent hepatic system lacks the regenerative capabilities of homosapiens in many respects.
In this instance the important difference is rodents are MUCH more apt to develop acute hepatic failure when exposed to the same toxins, that results in a more chronic or cumulative effect in humans.
Moreover rodents regenerative ability results in septa (spaces between liver cells) separation. This process would quite likely WORSEN any preexisting portal hypertension, which by definition every patient with cirrhosis has to one degree or another, and is a HUGE cause of mortality in humans. (These are good reasons to completely ignore AAS related hepatic dysfunction in rodents also IMO, especially those based on changes in hepatic enzymes)
Finally I could not locate any studies during my BRIEF Medline search in which Sulfasalazine was used as a form of PROPHYLAXIS, that is as a means of PREVENTING liver disease, which is the intent of using "liver protectors" while consuming oral AAS, right?
I mean the very reasoning for discontinuing ANY drug that causes liver toxicity is to PREVENT hepatic fibrosis, which exclusive of isolated forms of therapy such as interferon and antivirals for hepatitis, is largely irreversible!
Another salient yet overlooked difference in hepatic research is the livers NATURAL ability to restore functionality in spite of the abuse we "humans" impose upon it. It's a marvel we live beyond our "teen years", lol (However do media outlets mention this very important characteristic, most do NOT for a variety of reasons, yet unfortunately enhanced sales seems to be the primary motive, IMO)
No but the important point is how difficult it is to determine whether a specific therapy such as Sulfa is responsible for improvement, or was the livers regenerative capability the reason "reversal was noted"!
So what does my diatribe mean? I've seen this many times before: promising initial studies with a limited account of potentially responsible variables, small number of patients, animal models extrapolated to humans, etc, etc, etc.
Consequently, I see no use for Sulfasalazine as prophylaxis for AAS associated hepatic toxicity, especially considering how VERY RARE it is, excluding media hype to the contrary.
Thanks for the posts and commentary, its really appreciated because all on Meso may benefit, including yours truly
JIM
