RESUMEN
Hepatitis C virus [HCV] infection is one of the most common infectious diseases leading to high morbidity and mortality due to the development of liver fibrosis/cirrhosis and hepatocellular carcinoma [HCC]. Transforming growth factor-beta 1 [TGF-beta 1] is the most relevant growth factor that plays a role in induction of hepatic fibrogenesis through stellate cell activation, with a decrease in vitamin A storage in these cells. However, the impact of TGF-beta 1 and vitamin A depletion on initiation of liver neoplasia is controversial. In this study, we intended to evaluate hepatitis C viremia in association with serum levels of TGF-beta 1 and retinol binding protein [RBP], which has been considered to be a good and sensitive index of vitamin A depletion, to assess if there is a potential link between serum titer of HCV and those markers and their importance as risk factors for the development of HCC. Serum levels of TGF-beta 1 and RBP were assayed using commercial ELISA and radial immunodiffusion kits in 30 patients [15 with HCV infection and 15 with HCV infection associated with HCC] along with 10 healthy controls. Quantification of circulating HCV RNA by Real-time polymerase chain reaction was done using TaqMan probe technology. Alpha fetoprotein [AFP] levels and serum aminotransferases' activities were also measured. Serum levels of TGF-beta 1 were considerably higher in HCC and HCV groups compared to healthy controls [23.88 +/- 12.73 and 13.63 +/- 7.58 vs. 8.08 +/- 2.51, p<0.001, p<0.05 respectively]. Furthermore, patients having HCV infection associated with HCC showed significantly higher values of TGF-beta 1 than HCV group [23.88 +/- 12.73 vs. 13.63 +/- 7.58, p<0.01]. Serum RBP levels were 55.32 +/- 16.87, 51.30 +/- 20.10 and 35.11 +/- 16.21 in the controls, HCV and HCC patients respectively. There was a significant decrease in serum RBP levels in HCC group compared to HCV and control groups [p<0.05, p<0.01 respectively]. A positive correlation was found between hepatitis C viremia and serum TGF-beta 1 levels in all patients [p<0.05]. A negative correlation was observed between TGF-beta 1 and RBP, in particular, more evident in HCC group also between RBP and AFP but did not reach statistical significance. Neither Serum TGF-beta 1 nor RBP levels were correlated with aminotransferases' activities in HCV and HCC patients. The progressive increase in serum TGF-beta 1 associated with progressive reduction in serum RBP levels from controls to HCC patients suggest their tumor-promoting effect through facilitating TGF-beta 1-mediated liver fibrogenesis with progressive loss of vitamin A storage giving the chance for the tumor to grow. Correlation of hepatitis C viremia with serum TGF-beta 1 levels signifies that HCV proteins could induce expression of TGF-beta 1 and may contribute to liver carcinogenesis. Therefore, increased serum TGF-beta 1 associated with reduced RBP levels could be considered as risk factors for the evolution of HCC in HCV-infected patients
RESUMEN
This work studied the antibody profile, interferon-gamma [IFN-gamma] serum level and nutritional status among infected schoolchildren aged 11 years in a rural school in Abis 8 Village. Fecal examination showed that only 19 cases infected with Cryptosporidium and 10 children were free from parasites [controls]. The IgA, IgG and IgM serum levels in infected cases were within normal level, without significant differences as compared to controls. The IgE serum level was significantly high in infected children. The cytokine IFN-gamma was significantly lower in the infected cases as compared to controls. Malnutrition was diagnostic among infected children. The study showed that malnutrition is the important finding related to Cryptosporidium infection. Malnutrition decreased IFN- gamma, the recognized factor in protection from infection, and elevated serum IgE level