Modern hepatoprotection: a narrative review of existing approaches and prospects for the use of biotechnological drugs

Abstract

The prevalence of acute and chronic liver diseases is increasing worldwide, which affects the quality of life and can lead to dangerous, life-threatening complications. Almost 50.0 % of all cases of acute liver failure are caused by drugs, and the overall mortality due to drug-induced liver injury reaches 5.0–11.9 %. In 2020, the hospital incidence of diseases of the digestive organs in Ukraine amounted to 430,593 cases among the adult population, of which 11,976 were fatal. The aim of the study: to characterize modern approaches to hepatoprotection and prospects of biological therapy based on data from open sources of information. Materials and methods. Publications were selected based on the PubMed, ClinicalKey Elsevier, Cochrane Library, eBook Business Collection, and Google Scholar databases, which covered information about modern approaches to the treatment of liver diseases. Results. Patients with chronic liver disease are at risk of extrahepatic complications related to liver cirrhosis and portal hypertension, as well as organ-specific complications of certain liver diseases. These complications can impair the quality of life and increase morbidity and mortality before and after liver transplantation. With chronic damage to the liver by toxic substances, the development of fatty dystrophy against the background of connective tissue changes in the form of nonspecific reactive hepatitis is more often observed. Hepatoprotectors are a pharmacotherapeutic group of heterogeneous drugs that prevent the destruction of cell membranes and stimulate the regeneration of hepatocytes. According to the Anatomical Therapeutic and Chemical classification of drugs (ATC classification), hepatoprotectors take their place in the group of drugs affecting the digestive system and metabolism (A), intended for the treatment of diseases of the liver and biliary tract (A05). One of the promising directions of biological therapy in patients with liver pathology is the use of means obtained from the fetoplacental complex. Conclusions. Cell therapy in clinically significant volumes is an actual area of modern hepatology. The most promising directions of biological therapy in clinical hepatology are the use of mesenchymal stem cells, agents obtained from the fetoplacental complex, and gene therapy.