RESUMO
Background : chronic hepatitis C viral infection is typically characterized by slowly progressive hepatic fibrosis. However, it was recognized that some patients do not progress while others rapidly develop significant cirrhosis. Chronic HCV disease is characterized at the molecular and cellular level by macrophage together with Th-1 like inflammatory response and HSC activation. Genetic polymorphisms in antigen processing system have been linked to HCV progression. Recently, polymorphism in key inflammatory mediators known to be unregulated in chronic HCV such as MCP-1 which have been identified as correlates with more severe HCV disease
Aim of the work to evaluate an association between MCP-1 expression and the disease outcomes in patients with HCV
Material and methods : MCP-1 m RNA, total bilirubin , Albumin/globulin ratio, ALT, platelets count and prothrombin concentration were assessed in 10 health subjects, served as control and 20 patients evidenced with chronic hepatitis C [10 patients with liver cirrhosis and the other 10 patients without cirrhosis]. MCP-1 [mRNA] expression was quantified by real time PCR, total bilirubin, ALT and albumin/Globulin ratio were estimated by using Hitachi Modular DP automated from Roche Diagnostics. Assessment of prothrombin concentration and platelets count were performed by using sysmex coagulometer and Beckmam wulter, respectively
Results: MCP-1 mRNA levels were significantly higher in chronic hepatitis C patients when compared to control subjects [P< 0.0011. Also comparative studies showed that the levels of MCP-1 mRNA were significantly higher in cirrhotic group as compared to non cirrhotic group [PC 0.0011. The stepwise linear regression analysis revealed that Mcp-1 expression and total bilirubin were significantly better in identifying liver cirrhosis [P<0.001] than platelets count, PC and A/G ratio[P<0.05]. However, ALT was considered as excluded variable [P: 0.05]
Conclusion: we concluded that increased expression of MCP-1 mRNA may predispose HCV patients to more sever hepatic cirrhosis. Also, our study revealed the value of total bilirubin and MCP-1 expression in prediction of liver cirrhosis, these findings open the way to evaluate a strategy for anti MCP-1 gene therapy against hepatic cirrhosis