RESEARCHERS BEGIN STUDY TO UNDERSTAND WHY POPULAR MOOD BOOSTING REMEDY MAY HELP PATIENTS SURVIVE ALCOHOL RELATED LIVER DISEASE

Previous Study Showed that S-adenosylmethionine (SAM-e) Delayed Death or Liver Transplantation in Patients with Alcoholic Cirrhosis, Current Research Team Seeks Underlying Biochemical Reasons

LOS ANGELES, CA – Researchers at the University of Southern California (USC) began enrolling patients in a small, 1-year, double-blind, placebo-controlled clinical trial at the affiliated L.A. County Rancho Los Amigos National Rehabilitation Center (RLA) to understand why SAM-e, a dietary supplement used by hundreds of thousands of people in the United States as a mood booster, may be of critical importance to patients with alcoholic liver disease (ALD).

A previous trial demonstrated that SAM-e reduced mortality and improved survival time in patients with less severe alcoholic cirrhosis, an advanced stage of ALD. But the 2-year, double-blind, placebo-controlled trial, involving 123 patients given either a daily dose of 1,200 mg of SAM-e or placebo did not answer why, and few in the U.S. are aware of the results or that SAM-e is involved in the liver.

“Although SAM-e is a recent phenomenon to the U.S. public as an alternative medicine for depression, we as researchers have years of knowledge regarding its role in liver function,” says Dr. Hide Tsukamoto, Director of the USC-UCLA Research Center for Alcoholic Liver and Pancreatic Diseases. “Liver disease is a top killer in the U.S., especially among the Hispanic population, and despite the fact that public awareness is very low, the scientific community continues to make progress, and this study is an example of that progress.”

SAM-e

SAM-e is an important compound in all tissues and is made primarily in the liver as a result of methionine metabolism. Patients with ALD have abnormal methionine metabolism, which depletes SAM-e. Depleted SAM-e may affect the various liver functions that depend on it, including methionine metabolism itself, thereby contributing to the progression of the disease.

SAM-e came to the U.S. in 1999 as a dietary supplement known as a mood booster and was first approved as a prescription drug outside the U.S. in 1976. SAM-e is a prescription drug in some countries to treat depression, osteoarthritis, and liver disease. SAM-e is getting increased attention from the mainstream medical community, and a symposium on SAM-e in liver disease is scheduled in September at the National Institutes of Health. USC is one of the institutions presenting data at the symposium.

Alcoholic Liver Disease (ALD) and Alcohol Abuse

ALD is one of the most common liver diseases encountered in this country and is caused by alcohol abuse. There are three phases of ALD: fatty liver, which is usually reversible with abstinence; alcoholic hepatitis, or liver inflammation; and cirrhosis, or scarring of the liver. The 10th Special Report to the U.S. Congress on Alcohol and Heath estimates that 14 million Americans meet the diagnostic criteria for alcohol abuse and that there are, conservatively, 2 million Americans with ALD. There is currently no effective treatment for ALD, other than abstinence in the early phase, and the disease remains a leading killer of people each year in the U.S., especially among Hispanics.

Clinical trials using dietary supplements are rare due to the fact that there is little funding from the companies that sell them. USC is using a private donation to fund the current trial and hopes that more funding becomes available to study SAM-e in liver disease. “Completion of the current study will greatly advance our understanding of the role of altered methionine metabolism in the pathogenesis of alcoholic liver injury and the mechanism or mechanisms of SAM-e’s protective action,” says Dr. Michel Mendler, the principle investigator of the study. USC researchers already have experience with SAM-e in liver function from past and ongoing National Institutes of Health funded study at the basic science, or cellular level and hope that a better understanding of the biochemical changes that result with SAM-e administration in patients with ALD leads to new treatment options.

Rancho Los Amigos National Rehabilitation Center (RLA)

RLA is an L.A. County facility in Downey that cares for uninsured or those covered by Medical, as well as insured patients. Its patient population generally consists of those who are severely ill who most often are refused care elsewhere and are referred by other L.A. County facilities or the L.A. County+USC Medical Center. The current study is recruiting in-patients who are hospitalized there for acute alcoholic hepatitis, and is not open to voluntary enrollment from the general public.