Study of the correlation between; nitric oxide profile, degree of liver injury and structural vascular changes of the gastric mucosa in chronic hepatitis C virus related liver diseases

Nitric oxide [NO] plays an important role in HCV associated hepatic dysfunction and in the pathogenesis of portal hypertension. This study was designed to correlate serum nitrite and nitrate levels with the degree of liver injury and gastric mucosal changes in HCV patients at different stages of the disease. 80 HCV infected patients were classified equally into 4 groups; chronic hepatitis C, Child A, B and C cirrhosis groups. 20 healthy subjects were allocated as a control group. For all patients, serum nitrite and nitrate levels, HCV RNA and liver test profile were evaluated. Liver biopsies for chronic hepatitis C and Child-A cirrhotic patients were obtained for grading, staging and expression of interferon gamma [INF- gamma] and pentosidine. Esophagogastrodudenoscopy to evaluate the degree of portal hypertensive gastropathy [PHG] and expression of vascular endothelial growth [VEGF] by histopathology. Serum NO profile was significantly higher in all HCV infected patients than healthy subjects. A significant correlation between IFN-gamma expression and both of serum NO and viral load. Also, hepatic pentosidine expression was correlating with staging and fibrosis. Also both of serum NO and gastric VEGF were over expressed and correlating with the degree of PHG. In HCV infected patients, serum NO was significantly overexpressed and correlating with the severity of chronic liver disease. Our study supports the role of direct viral cytopathic effect in HCV patients because of the significant correlation of viral load with both of serum NO and hepatic IFN-gamma expression. Pentosidine might be considered a marker of oxidative stress and fibrosis in chronic HCV liver disease

Secretory IgA chronic hepatitis in patients with contaminated small bowel secondary to schistosomal hepatic fibrosis [SHF]

This work included 15 patients with SHF, portal hypertension complicated with chronic hepatitis and GIT bacterial overgrowth. Five normal persons were included as a control group for the bacteriological study. Clinical, bacteriologic, histologic and immunologic study were done for all patients. All patients were screened for HBsAg, HBeAg, and HCV antibody. All positive patients were excluded. Marked increase in bacterial counts were observed in the gastric aspirate and stool samples of patients. Histopathologic study revealed chronic active hepatitis in 13 patients and chronic persistent hepatitis in 2 patients. Immunohistochemical study using anti S-IgA antibody revealed positive staining in all cases while none of the control group showed positive staining. Therefore, S-IgA may be the cause of chronic hepatitis and it is highly related to mucosal infection, which is a common finding in cirrhotic patients