Letters to the Editors
Letter: coffee and chronic liver damage R. Cardin, M. Piciocchi & F. Farinati Department of Surgery, Oncology and Gastroenterology, Section of Gastroenterology, Padua University, Padua, Italy. E-mail: [email protected] doi:10.1111/apt.12637
SIRS, We read with interest the recent article on the potential approaches to the treatment of hepatitis C virus (HCV)-related hepatitis in patients either not eligible or not responding to interferon-based protocols.1 Sofosbuvir-based regimens will dramatically reduce the size of the problem,2 but still a share of patients will be not eligible for treatment and the behavioural and alimentary indications we give them will maintain a general relevance. One of the authors’ conclusions is that the consumption of two or more cups of coffee per day is recommended in patients with chronic HCV infection and in support of the thesis, we think it is useful to quote two results we recently reached. The first is that the daily consumption of three or more cups of coffee in patients with HCV-related liver disease is associated with a halving of the levels of 8-hydroxydeoxyguanosine (8-OHdG) in circulating nucleated cells. Eight-OHdG is a marker of free radical-mediated oxidative DNA damage, an adduct causing DNA mutation involved in carcinogenesis3 and its reduction supports the protective role of coffee in the development of advanced liver damage and HCC.4
Table 1 | Effects of coffee consumption/abstinence on telomere length, cytokeratin 18 (marker of apoptosis) and procollagen type III (marker of fibrogenesis) in HCV-related hepatitis patients Unit Telomere length
Arbitrary unit Cytokeratin 18 U/L Procollagen type III ng/mL
Coffee
Abstinence
Pvalue
0.68 0.06
0.48 0.04
0.006
649 93 86 21
0.04 0.04
712 89 56 9
Aliment Pharmacol Ther 2014; 39: 641-643 ª 2014 John Wiley & Sons Ltd
The second result is that, in a prospective randomised study on coffee consumption in patients with HCVrelated hepatitis, we demonstrated that drinking four cups of coffee per day is correlated with reduced collagen synthesis and oxidative DNA damage and an increase in telomere length and circulating markers of apoptosis5 (Table 1), both protective factors in liver carcinogenesis. HCV-related hepatitis is not the only potential target, as coffee may also be of benefit in non-alcoholic fatty liver disease (NAFLD), which is an additional risk factor for HCC,6 due to its protective effect also with respect to NAFLD progression.7 In summary, coffee appears to be protective in liver damage progression, irrespective of the aetiology. Its use should be recommended and the mechanisms and compounds involved further investigated.
ACKNOWLEDGEMENT Declaration of personal and funding interests: None. REFERENCES 1. Carreno V. Review article: management of chronic hepatitis C in patients with contraindications to anti-viral therapy. Aliment Pharmacol Ther 2014; 39: 148–62. 2. Gane EJ, Stedman CA, Hyland RH, et al. Efficacy of nucleotide polymerase inhibitor sofosbuvir plus the NS5A inhibitor ledipasvir or the NS5B non-nucleoside inhibitor GS-9669 against HCV genotype 1 infection. Gastroenterology 2013;. doi:10.1053/j. gastro.2013.11.007 [Epub ahead of print]. 3. Kuchino Y, Mori F, Kasai H, et al. Misreading of DNA templates containing 8-hydroxydeoxyguanosine at the modified base and at adjacent residues. Nature 1987; 327: 77–9. 4. Farinati F, Cardin R, Piciocchi M. Coffee, chronic diseases and cancer. Eur J Clin Nutr 2013; 67: 898. 5. Cardin R, Piciocchi M, Martines D, Scribano L, Petracco M, Farinati F. Effects of coffee consumption in chronic hepatitis C: a randomized controlled trial. Dig Liver Dis 2013; 45: 499–504. 6. Lade A, Noon LA, Friedman SL. Contributions of metabolic dysregulation and inflammation to nonalcoholic steatohepatitis, hepatic fibrosis, and cancer. Curr Opin Oncol 2014; 26: 100–7. 7. Bambha K, Wilson LA, Unalp A, et al. Coffee consumption in NAFLD patients with lower insulin resistance is associated with lower risk of severe fibrosis. Liver Int 2013;. doi:10.1111/liv.12379 [Epub ahead of print].
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Letter: coffee and chronic liver damage R. Cardin, M. Piciocchi & F. Farinati Department of Surgery, Oncology and Gastroenterology, Section of Gastroenterology, Padua University, Padua, Italy. E-mail: [email protected] doi:10.1111/apt.12637
SIRS, We read with interest the recent article on the potential approaches to the treatment of hepatitis C virus (HCV)-related hepatitis in patients either not eligible or not responding to interferon-based protocols.1 Sofosbuvir-based regimens will dramatically reduce the size of the problem,2 but still a share of patients will be not eligible for treatment and the behavioural and alimentary indications we give them will maintain a general relevance. One of the authors’ conclusions is that the consumption of two or more cups of coffee per day is recommended in patients with chronic HCV infection and in support of the thesis, we think it is useful to quote two results we recently reached. The first is that the daily consumption of three or more cups of coffee in patients with HCV-related liver disease is associated with a halving of the levels of 8-hydroxydeoxyguanosine (8-OHdG) in circulating nucleated cells. Eight-OHdG is a marker of free radical-mediated oxidative DNA damage, an adduct causing DNA mutation involved in carcinogenesis3 and its reduction supports the protective role of coffee in the development of advanced liver damage and HCC.4
Table 1 | Effects of coffee consumption/abstinence on telomere length, cytokeratin 18 (marker of apoptosis) and procollagen type III (marker of fibrogenesis) in HCV-related hepatitis patients Unit Telomere length
Arbitrary unit Cytokeratin 18 U/L Procollagen type III ng/mL
Coffee
Abstinence
Pvalue
0.68 0.06
0.48 0.04
0.006
649 93 86 21
0.04 0.04
712 89 56 9
Aliment Pharmacol Ther 2014; 39: 641-643 ª 2014 John Wiley & Sons Ltd
The second result is that, in a prospective randomised study on coffee consumption in patients with HCVrelated hepatitis, we demonstrated that drinking four cups of coffee per day is correlated with reduced collagen synthesis and oxidative DNA damage and an increase in telomere length and circulating markers of apoptosis5 (Table 1), both protective factors in liver carcinogenesis. HCV-related hepatitis is not the only potential target, as coffee may also be of benefit in non-alcoholic fatty liver disease (NAFLD), which is an additional risk factor for HCC,6 due to its protective effect also with respect to NAFLD progression.7 In summary, coffee appears to be protective in liver damage progression, irrespective of the aetiology. Its use should be recommended and the mechanisms and compounds involved further investigated.
ACKNOWLEDGEMENT Declaration of personal and funding interests: None. REFERENCES 1. Carreno V. Review article: management of chronic hepatitis C in patients with contraindications to anti-viral therapy. Aliment Pharmacol Ther 2014; 39: 148–62. 2. Gane EJ, Stedman CA, Hyland RH, et al. Efficacy of nucleotide polymerase inhibitor sofosbuvir plus the NS5A inhibitor ledipasvir or the NS5B non-nucleoside inhibitor GS-9669 against HCV genotype 1 infection. Gastroenterology 2013;. doi:10.1053/j. gastro.2013.11.007 [Epub ahead of print]. 3. Kuchino Y, Mori F, Kasai H, et al. Misreading of DNA templates containing 8-hydroxydeoxyguanosine at the modified base and at adjacent residues. Nature 1987; 327: 77–9. 4. Farinati F, Cardin R, Piciocchi M. Coffee, chronic diseases and cancer. Eur J Clin Nutr 2013; 67: 898. 5. Cardin R, Piciocchi M, Martines D, Scribano L, Petracco M, Farinati F. Effects of coffee consumption in chronic hepatitis C: a randomized controlled trial. Dig Liver Dis 2013; 45: 499–504. 6. Lade A, Noon LA, Friedman SL. Contributions of metabolic dysregulation and inflammation to nonalcoholic steatohepatitis, hepatic fibrosis, and cancer. Curr Opin Oncol 2014; 26: 100–7. 7. Bambha K, Wilson LA, Unalp A, et al. Coffee consumption in NAFLD patients with lower insulin resistance is associated with lower risk of severe fibrosis. Liver Int 2013;. doi:10.1111/liv.12379 [Epub ahead of print].
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