Article

Soluble inflammatory markers as predictors of liver histological changes in patients with chronic hepatitis C virus infection

Postgraduate Program on Infectious Diseases and Tropical Medicine, Medical School, Federal University of Minas Gerais, Av. Alfredo Balena, Belo Horizonte, Brazil.
European Journal of Clinical Microbiology (Impact Factor: 2.54). 09/2010; 29(9):1153-61. DOI: 10.1007/s10096-010-0981-4
Source: PubMed

ABSTRACT Host immune response seems to be mainly responsible for the progression of liver disease among patients with hepatitis C virus (HCV) infection. Immune activation involves the release of cytokines and their receptors that can be measured in plasma samples. The study aimed to evaluate the association between plasma levels of chemokines and soluble tumor necrosis factor receptors (sTNFR) and liver histological changes among patients with chronic HCV infection. Seventy-one treatment-naive patients were included. Plasma levels of CCL2, CCL3, CCL11, CCL24, CXCL9, CXCL10, sTNFR1, and sTNFR2 were measured and liver histological findings were reviewed. Plasma levels of CXCL9, sTNFR1, and sTNFR2 were significantly associated with liver fibrosis, with higher median levels found among patients with moderate/severe fibrosis (F >or= 2) if compared to those with no or mild fibrosis (p = 0.014; p = 0.012; p = 0.009, respectively). Plasma sTNFR2 levels were significantly associated with necroinflammatory activity, with higher median levels among patients with moderate/severe activity (A >or= 2) if compared to those with no or mild activity (2.34 ng/mL vs. 1.99 ng/mL; p = 0.019). In conclusion, plasma levels of CXCL9, sTNFR1, and sTNFR2 were independently associated with liver histological changes, suggesting a role of TNF activation and Th1-type cell-mediated immune response in the pathogenesis of HCV infection.

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    • "Other authors (Diago et al. 2006) propose that elevated CXCL10 levels may result in an accumulation of effector T cells in the liver and the selective pressure imposed by this accumulation may foster outgrowth of immune escape HCV mutants that would be more difficult to eradicate with combined therapy (Diago et al. 2006). The observed association between CXCL10 levels and therapeutic response was not mediated by liver histological changes, as plasma levels of this chemokine were not associated with liver inflammatory activity or fibrosis in a subanalysis of the dataset (Moura et al. 2010). CXCL9, which binds the same chemokine receptor as CXCL10 (i.e., CXC3), did not show an association with virological response in our study, in accordance with findings from a previous study conducted by Butera et al. (2005) "
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