Nonalkolik steatohepatit ve kronik hepatit C enfeksiyonu olan hastalarda serum kaspaz kırılmış sitokeratin-18 (Ck18-asp396) düzeyleri
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Date
2007
Authors
Yılmaz, Yusuf
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Apoptozisin kronik karaciğer hasarında önemli bir rol aldığına inanılmaktadır. Kaspaz-kırılmış proteinler apoptotik hücrelerden serbestleşir ve dolaşımda ölçülebilir. Kronik karaciğer hastalıklarında apoptozisin rolünü daha iyi kavramak amacıyla 35 nonalkolik steatohepatitli (NASH), 21 kronik hepatit C (HCV)’li hastada ve 18 sağlıklı kontrolde kaspaz-kırılmış sitokeratin-18 (CK18Asp396)’in serum seviyelerini ölçtük. CK18-Asp396 (M30-antijen) düzeyi ELISA yöntemiyle saptandı. Serum M30-antijen düzeyi sağlıklık kontrollerden (ortanca: 54,5 IU/L), HCV’li hastalara (80,1 IU/L) ve NASH’li hastalara (144,1 UI/L) doğru artış gösterdi. Serum M30-antijen düzeylerinin NASH’li hastalarda sağlıklı kontrollerden istatistiksel olarak anlamlı bir şekilde daha yüksek olduğu saptandı (p<0,001). Kronik hepatit C enfeksiyonlu hastaların M30-antijen düzeylerinin sağlıklı kontrollerinkinden yüksek saptanmasına rağmen iki grup arasında istatistiksel olarak anlamlı fark bulunmadı (p>0,05). Anormal M30-antijen düzeylerinin(>111,5 IU/L) %62,9 sensitivite %100 spesifite ile NASH ‘li hastaları sağlıklı kontrollerden ayırdığı görüldü. NASH’li ve kronik hepatit C enfeksiyonlu hastaların hem histolojik aktivitesinin derecesi hem de fibrozis evresi ile M30-antijen düzeyi arasında anlamlı bir korelasyon saptanmadı. Neticede bu sonuçlar, serum M30-antijen belirtecinin işaret ettiği apoptotik proçesin NASH patogenezindeki rolünün daha önemli olabileceğini, ancak gerek kronik hepatit C enfeksiyonlu gerekse NASH’li hastalarda karaciğerin histolojik bulguları ile korelesyon göstermediğini düşündürmektedir. Bulgularımızı konfirme edecek daha büyük hasta gruplarıyla yapılacak çalışmalara ihtiyaç vardır.
Apoptosis is deemed to play a crucial role in chronic liver injury. Caspasecleaved proteins are released from apoptotic cells and may be measured in the circulation. To gain more insight into the role of apoptosis in chronic liver disease, we examined serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) in 35 patients with nonalcoholic steatohepatitis (NASH), 21 patients with chronic hepatitis C (HCV) and 18 healthy controls. CK18-Asp396 levels were assessed by means of ELISA. Analysis of serum CK18-Asp396 levels showed an increasing trend starting from healthy controls (median: 54.5 IU/L), through HCV patients (80.1 IU/L) up to patients with NASH (144.1 UI/L). It was detected that serum M30 antigen levels of patients with NASH were higher than healthy controls in a statistically significant manner (p< 0.001). Although M30 antigen levels of patients with chronic hepatitis C infection were higher than healthy controls, no statistically significant difference was found between two groups (p>0.05). It was seen that abnormal M30 levels (>111.5 IU/L) distinguished patients with NASH from healthy controls with 62.9 % sensitivity 100% specifity. No significant correlation was found between both histological acitivity level and fibrosis phase and M 30 antigen levels of patients with NASH and chronic hepatitis C infection. In conclusion, these results make us think that apopytotic process pointed out by serum M30 antigen marker might be more important in NASH pathogenesis however it does not show any correlation with liver histological findings of patients with NASH and chronic hepatitis C. Further studies on larger groups of patients are needed to confirm our pilot findings.
Apoptosis is deemed to play a crucial role in chronic liver injury. Caspasecleaved proteins are released from apoptotic cells and may be measured in the circulation. To gain more insight into the role of apoptosis in chronic liver disease, we examined serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) in 35 patients with nonalcoholic steatohepatitis (NASH), 21 patients with chronic hepatitis C (HCV) and 18 healthy controls. CK18-Asp396 levels were assessed by means of ELISA. Analysis of serum CK18-Asp396 levels showed an increasing trend starting from healthy controls (median: 54.5 IU/L), through HCV patients (80.1 IU/L) up to patients with NASH (144.1 UI/L). It was detected that serum M30 antigen levels of patients with NASH were higher than healthy controls in a statistically significant manner (p< 0.001). Although M30 antigen levels of patients with chronic hepatitis C infection were higher than healthy controls, no statistically significant difference was found between two groups (p>0.05). It was seen that abnormal M30 levels (>111.5 IU/L) distinguished patients with NASH from healthy controls with 62.9 % sensitivity 100% specifity. No significant correlation was found between both histological acitivity level and fibrosis phase and M 30 antigen levels of patients with NASH and chronic hepatitis C infection. In conclusion, these results make us think that apopytotic process pointed out by serum M30 antigen marker might be more important in NASH pathogenesis however it does not show any correlation with liver histological findings of patients with NASH and chronic hepatitis C. Further studies on larger groups of patients are needed to confirm our pilot findings.
Description
Keywords
Alkolik olmayan steatohepatit, Kronik hepatit C, Apoptozis, Histopatoloji, Biyobelirteç, Nonalcoholic steatohepatitis, Chronic hepatitis C, Apoptosis, Histopathology, Biomarker
Citation
Yılmaz, Y. (2007). Nonalkolik steatohepatit ve kronik hepatit C enfeksiyonu olan hastalarda serum kaspaz kırılmış sitokeratin-18 (Ck18-asp396) düzeyleri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.