ABSTRACT
Aim: The objective of this work is to find out whether there is a relation between the expression of TLR4 and fibrosis progression in chronic HCV patients
Background: Toll-like Receptor 4 [TLR4] is a pattern recognition receptor whose activation results in the production of several pro-inflammatory cytokines
Methods: Fifty patients with chronic HCV were included. They were divided into group A: 40 patients [F1-F4] and group B [control group] which included ten patients [F0] based on fibroscan value. All patients were exposed to clinical and laboratory evaluations preliminary to antiviral therapy, assessment of TLR4 mRNA by Real Time- PCR
Results: Twenty-eight males and 22 females with a mean age 28.9 +/- 6.1 years. The mean TLR4 expression is 11.2 +/- 7.4 folds, TLR4 expression in F0 group is 2.8 +/- 1.9, in F1 group 4.8 +/- 1.5, F2 group 10.2 +/- 2.5, F3 group 16.8 +/- 1.5 and in F4 21.3 +/- 3.6 folds [p<0.001]. TLR4 showed a positive correlation with age, fibrosis stage, HCV RNA, serum transaminases, total bilirubin and prothrombin time, a negative correlation with platelet count and serum albumin. Fibrosis progression was independently associated with TLR4 expression [beta=0. 648, P<0.0001], RNA [beta= 0.160, P =0.001] and platelet count [beta= -0.248, P = 0.004]
Conclusion: The expression of TLR4 is highly correlated with the fibrosis progression; TLR4 may be a potential target for drugs to limit the progression of fibrosis