Metallothionein [MTI and MT II] gene expression in hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most frequent human tumors worldwide, and commonly evolves from chronic hepatitis and liver cirrhosis. It is therefore very important to detect and evaluate the progressing state of chronic hepatic disorders. Recently, serum metal levels such as copper [Cu] and zinc [Zn] have been reported to be highly sensitive in the diagnosis of some diseases. Hypozincemia and marked hypercupremia have been reported in patients with digestive, hepatic, breast, and lung cancers. Also much attention was paid to the association between metallothioneins [MTs] and chronic liver diseases including HCC. Available informations suggested that MTs might play important roles in carcinogenic and apoptotic process of some tumors. The aim of the present study was to throw the light on the role of zinc, copper and metallothioneine in the diagnosis of chronic liver diseases and to clarify the role of metallothioneins [MTs] I and II mRNA expression in hepatocellular carcinoma. This study was carried out on 45 patients with liver diseases [15 patients with chronic hepatitis, 15 patients with liver cirrhosis and 15 patients with HCC] as well as 15 healthy individuals as a control group. All patients and controls were subjected to estimation of serum copper, zinc and metallothioneine levels also their tissue levels were estimated in all patient groups. Metallothioneins [MT I and MT II] mRNA expression by RT-PCR were done for all cases. The results of the present study documented a significant decrease in serum and tissue levels of zinc and metallothioneine with concomitant increase in copper levels in all patient groups. More changes were documented in HCC patients. Concerning the PCR results of MT genes expression, there was a significant decrease in MT I and MT II mRNA expression in HCC patients when compared to the other groups. They also decreased in patients with liver cirrhosis when compared to the control group and patients with chronic hepatitis. In contrast their expressions do not show significant decrease in chronic hepatitis when compared to the control group. On the basis of these results, it could be concluded that serum zinc, copper, and metallothioneines levels may be used as a non-invasive biochemical markers for early detection of the progression of chronic liver diseases. Moreover, the progressive decrease in MT I and MT II gene expression may play an important role in carcinogenesis of HCC

Evaluation of renal arterial blood flow in patients with various stages of schistosomal hepatic fibrosis by duplex ultrasonography

Studies of renal perfusion when kidney function tests are still normal could be useful to understand the pathophysiology of renal impairment in schistosomal hepatic fibrosis; currently, this requires invasive methodology. Duplex Doppler ultrasonography allows noninvasive evaluation of intrarenal arterial resistances. In 40 patients with schistosomal hepatic fibrosis [10 with hepatomegaly, 10 with hepatosplenomegaly, 10 with shrunken liver and splenomegaly, and 10 with shrunken liver, splenomegaly and ascites] with normal kidney function [normal serum creatinine and urea levels] and in 20 healthy controls, we measured the intrarenal arterial resistivity index [Resistivity index = [Peak systolic velocity - Minimum diastolic velocity]/Peak systolic velocity] and the pulsatility index [Pulsatility index = [Peak systolic velocity - Minimum diastolic velocity]/ Mean velocity] by Duplex Doppler ultrasonography after visualization of interlobar, interlobular or arcuate arteries by color Doppler ultrasonography. The resistivity index and pulsatility index [calculated as the mean of three to five consecutive determinations] were significantly higher in patients with shrunken liver and splenomegaly than in controls or in patients with hepatomegaly only. Also, these indices were significantly higher in patients with shrunken liver, splenomegaly and ascites than in controls or other patients included in this study. On the basis of these results, Duplex ultrasonography is useful in pathophysiology and clinical studies in such patients