[Methods of early diagnostics of hepatic fibrosis and cirrhosis].

The article covers the functional and clinical importance of hepatic fibrosis. Contemporary principles of invasive and non-invasive diagnostics of fibrotic changes are described. The article deals with the main types of fibrosis, chronic hepatic diseases in which they develop, and the most wide-spread systems of semiquantitative evaluation of fibrotic process' morphologic signs.

[Current methods of early diagnosis of hepatic fibrosis].

The article covers the functional and clinical significance of hepatic fibrosis. Contemporary principles of invasive and non-invasive methods of diagnostics of fibrotic alterations are described. The article also covers the main forms of fibrosis, chronic hepatic diseases in which they are found, and the most wide-spread systems of half-quantitative evaluation of morphological signs of the fibrotic process.

[Cytokine system in patients with chronic hepatitis C during treatment with interferon-alfa]. / Sistema tsitokinov u bol'nykh khronicheskim gepatitom C pri lechenii interferonom-al'fa.

AIM: To study changes in serum levels of interleukine-1 beta (IL-1b), IL-6, TNF-alpha (TNFa), HM-HMF and TFR-1 beta (TFR-1b), expression of surface antigens CD14 and CD95 on blood monocytes from patients with chronic hepatitis C (CHC) treated with interferon-alpha (INFa). MATERIAL AND METHODS: Examinations covered 25 CHC patients and 25 healthy controls. Concentrations of proinflammatory cytokines and growth factors in blood serum were measured with ELISA (kits by "R&D systems", USA). CD14 and CD95 antigen expression on monocytes of venous blood were studied using flow cytoflowmeter (Partes, USA) before and after a 12-week course of INFa. RESULTS: Before INFa treatment CHC patients had significantly elevated serum concentrations of TNFa, HM-KSF and TFR-1b. Coexpression of antigens CD14+ and CD95+ was found on 61% of blood monocytes. Three-month INFa treatment lowered levels of TNFa, GM-KSF and CD95+ expression on monocytes as well as TFR-1b concentration in the serum which correlated with a positive trend in the standard clinicolaboratory and virusological indices in the examinees. CONCLUSION: Changes in serum indices of proinflammatory cytokines and growth factors, in expression of CD95 on blood monocytes from CHC patients treated with INFa show an important role of cytokines system activation and mechanisms of programmed cell death in pathogenesis of chronic HCV infection.

[Cytokine production in patients with chronic viral hepatitis C during treatment with interferon-alpha]. / Produktsiia tsitokinov u bol'nykh khronicheskim virusnym gepatitom C na fone terapii interferonom-alpha.

Serum content of proinflammatory cytokines (IL-1 beta, IL-6, TNF-alpha) and growth factors (GM-CSF, TGF-1 beta) and expression of CD14 and CD95 antigens on peripheral blood monocytes before and after 12-day therapy with alpha-interferon were studied in 25 patients with chronic viral hepatitis C (VHC). The concentrations of TNF alpha, GM-CSF, and TGF-1 beta were significantly increased (p < 0.05) and coexpression of CD14+ and CD95+ antigens on monocytes was increased by 61% in VHC patients in comparison with the control. After 3 months of therapy with alpha-interferon, the content of TNF alpha, GM-CSF, and TGF-1 beta essentially decreased and that of IL-6 increased; this was paralleled by improvement of clinical and laboratory parameters and decrease of coexpression of CD14+ and CD95+ antigens on blood monocytes. Modulation of the functions of immunocompetent cells and changed production of cytokines are apparently one of the mechanisms of inhibitory effect of alpha-interferon on HCV infection. Study of proinflammatory cytokines and growth factors in the serum and expression of CD14 and CD 95 antigens on monocytes can serve as additional tests for evaluating the efficiency of interferon therapy in patients with VHC.

[Cytokine regulation of liver inflammation and fibrosis during chronic hepatic diseases]. / Reguliatsiia vospaleniia i fibroza pecheni tsitokinami pri ee khronicheskikh porazheniiakh.

Serum concentrations of antiinflammatory cytokines and growth factors were measured in 30 patients with chronic viral hepatitis (HCV), mainly HCV RNA, and 10 patients with liver cirrhosis (LC), classes B and C according to Child-Pew. Serum concentrations of tumor necrosis factor-alpha (TNF alpha), granulocytic-macrophagal colony-stimulating factor (GM-CSF), and growth-transforming factor-1 beta (TGF1 beta) were increased in 63.86 and 80% patients with HCV and LC, respectively, and differed significantly (p < 0.05) from the control. The level of TNF alpha positively correlated with the concentration of alanine aminotransferase (r = 0.14). A positive correlation between TGF1 beta and histologic activity index was detected (r = 0.16). Increased levels (p < 0.05) of IL-5, TNF alpha, and TGF1 beta were detected in LC patients in comparison with the control. Patients with LC concomitant with anemia had higher (though not significantly) concentrations of TNF alpha in comparison with patients without anemia. Increased levels of proinflammatory cytokines and growth factors in the sera of patients with HCV and LC indicate activation of immunocompetent cells, including mononuclear phagocytes. These data are in line with experimental findings, indicating an important role of the studied cytokines in the development of hepatic inflammation, fibrosis, and cytopenic syndromes.