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1.
Hepatogastroenterology ; 56(93): 1146-51, 2009.
Article in English | MEDLINE | ID: mdl-19760959

ABSTRACT

BACKGROUND/AIMS: Increased serum iron indices and hepatic iron stores are frequent in patients with chronic hepatitis C (CHC). The antimicrobial peptide hepdicin produced in the liver plays a pivotal role in iron homeostasis. METHODOLOGY: To determine the expression of hepcidin, the serum levels of prohepcidin were measured in 58 CHC patients and 144 healthy controls. The hepatic iron stores were scored by Perls' stain on liver biopsy specimens in 39 CHC patients. The serum prohepcidin levels were correlated with biochemical inflammation markers, histological necroinflammation grades, hemoglobin levels and iron status in CHC patients. RESULTS: The concentrations of serum prohepcidin were significantly higher in CHC patients than in healthy controls (142.07 +/- 67.06 vs. 89.07 +/- 37.32 ng/mL, p < 0.001). The CHC patients with positive hepatic iron stains had significantly higher serum prohepcidin levels than the CHC patients without (221.20 +/- 117.74 vs. 123.81 +/- 60.53 ng/mL, p = 0.037). The serum prohepdicin levels were not significantly correlated with the ages (r = -0.041, p = 0.760), hemoglobin (r = 0.127, p = 0.346), alanine aminotransferase (r = -0.032, p = 0.813), transferrin saturation (r = 0.025, p = 0.862), ferritin levels (r = 0.211, p = 0.133) and hepatic inflammation grades (r = 0.153, p = 0.352) in CHC patients. CONCLUSIONS: The expression of serum prohepcidin is independent of the degree of hepatic inflammation as measured by the histological activity or aminotransferase level. The serum prohepcidin levels are associated with hepatic iron stains and significantly higher in CHC patients than in healthy controls. Our results suggest that CHC may induce the expression of hepcidin possibly by increased hepatic iron stores.


Subject(s)
Antimicrobial Cationic Peptides/blood , Hepatitis C, Chronic/metabolism , Iron/metabolism , Liver/metabolism , Protein Precursors/blood , Biopsy , Case-Control Studies , Chi-Square Distribution , Female , Hepcidins , Humans , Liver Function Tests , Male , Middle Aged , Statistics, Nonparametric
2.
Hepatogastroenterology ; 55(85): 1412-5, 2008.
Article in English | MEDLINE | ID: mdl-18795701

ABSTRACT

BACKGROUND/AIMS: Mild to moderate iron overload is common in chronic hepatitis C (CHC) and may influence the response to antiviral therapy. The aim of this study was to assess the association among serum iron indices, hepatic iron stores and sustained virological response (SVR) rates of combination therapy with peginterferon alfa and ribavirin in patients with CHC. METHODOLOGY: A total of 36 CHC patients were treated with peginterferon and ribavirin for 6 months. The SVR was defined as undetectable hepatitis C virus RNA by qualitative assay 6 months after the end of therapy. The serum iron indices including ferritin, iron and transferrin saturation were measured. The hepatic iron deposition was graded on Perls' stain. RESULTS: The SVR was obtained in 25/36 (69.44%) patients. The serum iron indices including transferrin saturation and ferritin were not significantly different between patients with the SVR and without. In multivariate logistic regression analysis, cirrhosis (P = 0.010, odds ratio = 0.020) and a positive hepatic iron stain (P = 0.046, odds ratio = 0.065) were both significantly independent predictors of non-SVR. CONCLUSIONS: The findings suggest that the positive hepatic iron stain is an independent predictor of non-response to combination therapy with peginterferon alfa and ribavirin for patients with CHC. Liver cirrhosis also predicts non-responses to the combination therapy.


Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/drug therapy , Interferon-alpha/therapeutic use , Iron/blood , Polyethylene Glycols/therapeutic use , Ribavirin/therapeutic use , Adult , Aged , Antiviral Agents/administration & dosage , Drug Therapy, Combination , Female , Ferritins/blood , Humans , Interferon alpha-2 , Interferon-alpha/administration & dosage , Male , Middle Aged , Polyethylene Glycols/administration & dosage , Predictive Value of Tests , Recombinant Proteins , Ribavirin/administration & dosage , Transferrin/metabolism , Treatment Outcome , Viral Load
3.
World J Gastroenterol ; 11(25): 3905-8, 2005 Jul 07.
Article in English | MEDLINE | ID: mdl-15991291

ABSTRACT

AIM: To assess the prevalence of the two mutations, C282Y and H63D of HFE gene, in healthy subjects, patients with chronic hepatitis C (CHC), and patients with nonalcoholic fatty liver disease (NAFLD) in Taiwan and to explore the contribution of the HFE mutation on serum iron stores in CHC and NAFLD groups. METHODS: We examined C282Y and H63D mutations of HFE gene in 125 healthy subjects, 29 patients with CHC, and 33 patients with NAFLD. The serum iron markers, including ferritin, iron, and total iron binding capacity (TIBC), were assessed in all patients. RESULTS: All of the healthy subjects and patients were free from C282Y mutation. The prevalence of H63D heter-ozygosity was 4/125 (3.20%) in healthy subjects, 2/29 (6.90%) in CHC group, and 1/33 (3.03%) in NAFLD group. The healthy subjects showed no significant difference in the prevalence of H63D mutation as compared with the CHC or NAFLD group. Increased serum iron store was found in 34.48% of CHC patients and 36.36% of NAFLD patients. In three patients of H63D heterozygosity, only one CHC patient had increased serum iron store. There was no significant difference in the prevalence of HFE mutations between patients with increased serum iron store and those without in CHC or NAFLD group. CONCLUSION: The HFE mutations may not contribute to iron accumulation in the CHC or NAFLD group even when serum iron overload is observed in more than one-third of these patients in Taiwan.


Subject(s)
Fatty Liver/genetics , Gene Frequency , Hepatitis C, Chronic/genetics , Histocompatibility Antigens Class I/genetics , Iron/blood , Membrane Proteins/genetics , Mutation , Adult , Aged , Aged, 80 and over , Case-Control Studies , Fatty Liver/blood , Female , Hemochromatosis Protein , Hepatitis C, Chronic/blood , Heterozygote , Humans , Male , Middle Aged , Taiwan
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