Matrix metalloproteinase-9 [Mmp-9] circulating intercellular adhesion molecule-1 [Cicam-1], and procollagen III peptide [PIIIP] in hepatocellular carcinoma and various chronic liver diseases

A sound predictive test is lacking for the identification of cirrhotic patients at high risk of developing hepatocellular carcinoma. In the present study, plasma MMP-9, plasma clCAM-1, serum alpha-feto protein [AFP] and serum PIIIP levels were measured and evaluated in 30 patients suffered from chronic hepatitis [CH], 30 patients suffered from liver cirrhosis [LC] and 30 patients suffered from hepatocellular carcinoma [HCC], in addition to 30 normal healthy individuals as a control group using RIA method for estimation of PIIIP and ELISA methods for estimations of the AFP and clCAM-1 and MMP-9. The study showed that the mean values of plasma MMP-9, plasma clCAM-1, serum PIIIP and serum AFP levels were 44.8 ng/ml, 232.1 ng/ml, 3.4 ug/l, 3.2 ng/Ml respectively among control group, 88.61 ng/ml, 489.5 ng/ml, 11.5 ug/l, 8.7 ng/ml respectively among Chronic hepatitis patients, 96.6 ng/ml, 781.3 ng/ml, 13.9 ug/l, 26.5 ng/ml respectively among Liver cirrhosis patients and 212.1 ng/ml, 999.4 ng/ml, 26.6 ug/l, 784.6 ng/ml respectively among HCC patients. Plasma MMP-9, plasma clCAM-1, serum PIIIP and serum AFP showed statistically highly significantly increase in all patients groups [P <0.001] when compared with the healthy control group. Plasma MMP-9 showed statistically highly significant increase in HCC group when compared with CH and LC groups, while did not show any statistically significant change [P> 0.05] in CH and LC groups when compared with the control group or with each other. clCAM-1 showed statistically highly significant increase in LC and HCC groups when compared with CH group with no significant change between LC and HCC groups and lastly serum AFP and PIIIP levels showed statistically highly significantly increase in HCC group when compared with CH and LC groups. As regard HCC histopathological grading all measured parameters showed statistically nonsignificant changes in different HCC grades except MMP-9 which showed a statistically significant increase in grade III when either compared with grade I or grade II. Receiver operating characterstic curve [ROC curve] was constructed using multiple cut off points for every studied parameter and calculating the sensitivity and the specificity at each cut off point and also calculating the area under each curve. The optimum cut off point for diagnosis of HCC from CH and LC for plasma MMP-9, plasma clCAM-1, serum PIIIP, and serum AFP were 89.8 ng/ml, 905 ng/ml, 25.8 ug/L and 68 ng/ml respectively, also, the study showed that AFP was the best of the studied HCC markers as it had the biggest area under ROC curve [0.86] followed by MMP-9 [0.76], cICAM [0.715] and lastly PIIIP [0.71]

Endothelin-1 [ET-1] concentrations in plasma and bronchoalveolar lavage of some asthmatic patients

Endothelin-1 [ET-1] is a potent bronchoconstrictor which may have a role in the pathogenesis of asthma. To clarify the interrelation between ET-1 and bronchial asthma, the concentrations of ET-1 in plasma and BAL fluid were measured [by ELISA technique] in [10] healthy subjects, [10] patients with atopic asthma treated with bronchodilators alone [Group 1], and [10] patients with atopic ashma treated with inhaled an/or oral corticosteroids [Group II]. Pulmonary functions [FEV1% predicted and FEF25-75% predicated] and the provocation concentrations of methacholine required to reduce FEV1 by 20% of the prechallenge baseline [PD20 were also measured. There was no significant difference in the plasma ET-1 level among either the control group and group 1 [15.95 +/- 6.5 pg/ml versus 17.84 +/- 7.8 pg/ml][and group II [15.95 +/- 6.5 pg/ml versus 16.75 +/- 6.7 pg/ml] or group I and II [17.84 +/- 6.7 pg/ml]. There was a significant increase in BAL fluid ET-1 levels in both the non steroid treated patients with asthma [Group I] and the steroid treated patients [Group II] compared with the normal subjects [20.94 +/- 3.96 pg/ml versus 15.61 +/- 3.37 pg/ml][and [16.03 +/- 3.5 pg/ml] respectively. There was statistically significant difference in BAL ET-1 level between Group II and group I indicating that ET-1 level may be modulated by corticosteroid therapy. In group I and II there was a significant negative correlation between the BAL ET-1 concentrations and ventilatory functions [% predicated FEV1 and FEF25-75].No correlation between BAL fluid ET-1 concentrations and bronchial reactivity or plasma ET-1 level was found in either Group I and II. These findings indicate that the potent bronchoconstricitive substance, endotheline, may contribute to pathogenesis of airflow obstruction in asthma