Circulating solube vascular cell adhesion molecule-1[SVCAM-1] concentration in patients with chronic active hepatitis [C] with and without bilharziasis

The Serum levels of circulating Soluble Vascular Cell Adhesion Molecule-1 [SVCAM] were estimated by technique in sixty patients with chronic active hepatitis type C infection with [Group A] and without Bilharziasis [Group B], in addition, twenty apparently healthy subjects as a control group [Group C]. The mean SVCAM-1 levels pg/ml were markedly elevated in sera of diseased groups compared to control group [Group C] P<0.01]. Moreover, the mean sera levels of SVCAM-1 were increased [P<0.05] in active bilharziasis [Group B1] compared to inactive bilharziasis [Group B2]. There was a higher proportion of patients with CAH post C with or without Bilharziasis at least grade 3 inflamations on liver biopsy who had serum SVCAM-1 levels above this mean level [P<0.01]. These results might help understanding of the pathophysiology of CAH type C with and without Bilharziasis and this parameter may be helpful as an immunological marker of HCV liver disease reflecting ongoing immune-mediated pathology

Clinco-biochemical, virological and histopathological evaluation of dimethyl biphenyl dicarboxylate [DDB] in treatment of chronic HCV infection in Egyptian patients

The present study was designed to evaluate the efficacy and safety of DDB and DDB- amantadine HCL combined therapy in treatment of patients with chronic HCV infection for 6 months. The study included 90 patients with chronic HCV were selected and divided into three groups: Group 1: [Control group] included 30 patients of chronic HCV infection treated by silymarin for 6 months in a dose of 420 mg / day in three divided doses. Group II: [DDB group] included 30 patients of chronic HCV infection treated by DDB for 6 months in a dose of 15 pilules bid, each pilule 1.5mg Group III: [Combined group] included 30 patients of chronic HCV infection treated by DDB and amantadine HCL for 6 months. Amantadine HCL was given in a dose of 100mg twice daily. Good history taking and clinical examinations, also laboratory investigations including complete liver functions [AST, ALT, S. Bilirubin, S. Albumin, alpha fetoprotein and prothrombin time and concentrations], kidney functions tests, Quantitative HCV RNA PCR and histopathological examination before and at the end of therapy for some selected cases. Follow up of these cases 3 and 6 months revealed that:- there was statistically significant in the main clinical symptoms [Fatigue, Rt hypochondrial pain and epistaxis] and in the mean serum, transaminasis [ALT and AST] more in group III than G II in comparison to the control group. In addition, there were no improvements statistically significant between groups in the mean serum albumin, alpha feto-protein, prothromibin time and concentration, serum bilirubin, hematological parameters and kidney function before and after treatment. The results showed that there was decrease in the viral load at the end of treatment in group III than group II in comparison to the control group but no patients turned negative for HCV RNA PCR. Also, there were improvements statistically at the end of treatment in the degree of the histological criteria [Steatosis, lymphocytes infiltration and bile duct injury] in g II than G II in comparisons to the control group. Finally, it has concluded that DDB is beneficial drugs for treatment of chronic HCV patients and the additive value of DDB as immunomodulorty to amantadine HCL as anti viral as a combined therapy in chronic HCV infections is a new beneficial strategy

Study of interferon-gamma in Egyptian patients with chronic active hepatitis [C] versus chronic active hepatitis [B]

Pro-inflammatory cytokines include many factors as interferon Gamma [INF-Y]. In this study, we estimate the serum levels of INF-Y in sixty cases and twenty controls by ELISA technnique. They were classified as follows: - [30] Cases with chronic active hepatitis post C [group I], [30] cases with chronic active hepatitis post B [group II] and [20] normal healthy subjects as control group [group III]. The obtained results revealed that the mean INF-Y levels were markedly elevated [P.<0.001] in diseased groups [GI and GII] compared to control group [GIII]. Moreover, the mean serum levels of INF-Y were increased in CAH post C compared to CAH post B. we conclude that viral specific activated T-cell response oceues in CAH type C or type B with subsequent release and elevation of INF-Y, Also, this increase of INF-Y is related to viral activity and vigorous progressive liver injury may follow CAH-post virus C more than CAH post virus B

Significance of circulating intercellular adhesion molecules [sICAM-1] and thrombopoietin [TPO] in hepatitis C vinis related liver cirrhosis

Chronic hepatitis C is a major health problem that causes mortality in the worldwide distribution. The systemic levels of many soluble adhesion molecules and cytokines are altered in autoimmune diseases and liver infection. Among mediators that show altered serum levels are sICAM-1 expressed by immunocompetent cells and thrombopoitin [TPO]. The aim of this study was to evaluate the serum sICAM and TPO and their correlations with clinical and laboratory data in patients with hepatitis C-related cirrhosis. 40 patients with HCV-related cirrhosis and 20 healthy subjects were enrolled in this study. They were subjected to the following investigations: complete blood picture, liver and kidney functions, prothrombin time[PT], abdominal sonography and estimation of serum TPO and sICAM-1. Compared to controls, the patients group showed significant increase in spleen size [P<0.025], portal vein diameter [P<0.0025], ALT, AST, bilirubin, sICAM-1 [P<0.0005], and PT [P<0.05]. However there was significant decrease in serum albumin levels [P<0.01], platelets count [P<0.0005], RBCs count, haemoglobin concentrations [P<0.025] and serum TPO levels [P<0.0025]. The serum creatinine levels and WBCS count showed insignificant changes with control. The serum TPO levels were negatively correlated to ALT [r=-0.97, P<0.0001], PT [r=-0.96, P<0.0001], spleen size [r=-0.95, P<0.0001], and portal vein diameter [r=-0.96, P<0.0001] and positively correlated to platelets [r=0.84, P<0.0005]. While serum sICAM-l were positively correlated to ALT [r=0.99, P<0.0001], PT [r=0.94, P<0.0005], spleen size [r=0.95, P<0.0001], and portal vein diameter [r=0.85, P<0.005] and negatively correlated to platelets count [r=-0.7l, P<0.005]. Our results suggested that impaired synthesis of TPO by cirrhotic liver may contribute to the development of thrombocytopenia and related to liver cirrhosis together with increased splenic sequestration of platelets by the enlarged spleen. So recombinant human TPO should be evaluated in the treatment of thrombocytopenia in HCV-related cirrhosis. In addition, sICAM-1 elevation in plasma of patients suffering from HCV-related cirrhosis was related to the degree of cirrhosis and portal hypertension. So, sICAM-1 may be used as a marker of the disease activity and may provide diagnostic and prognostic information. However this needs to be further studied to detect the cut off level of sICAM-1 in Egyptian HCV-related liver cirrhosis