慢性肝疾患と鉄代謝

Chronic liver diseases and iron metabolic disorder

肝疾患に伴う二次的な鉄代謝障害が肝疾患の病態をさらに修飾していることが多い．C型慢性肝炎や非アルコール性脂肪性肝炎(NASH)では軽微な肝内鉄蓄積を伴うことがあるが，この軽微な鉄蓄積は肝病態に影響を与え，時に肝発癌の危険性を高める．鉄蓄積機序は完全には解明されていないが，C型慢性肝炎では鉄を負に制御するヘプシジンの産生低下が原因のひとつと考えられている．しかし，NASHにおける鉄蓄積機構はさらに多様で，種々の原因が関与していると考えられる．

The liver is the major iron storage organ in the body and therefore iron metabolic disorder is sometimes involved in chronic liver diseases.　Chronic hepatitis C and nonalcoholic steatohepatitis are one of the liver diseases that show hepatic iron accumulation, even though the level of hepatic iron is not extremely high.　However, it should be recognized that even mild to moderate hepatic iron accumulation contributes to the progression of these liver diseases including the development of hepatocellular carcinoma.　The mechanisms underlying hepatic iron accumulation still remain to be elucidated, even though suppression of hepcidin transcription may be involved in chronic hepatitis C.