Aralik 2018
Kronik viral hepatitler, karaciger sirozu ve hepatosellüler karsinomada inflamasyon göstergesi olarak neopterin
Neopterin as an indicator of inflammation in chronic viral hepatitis, liver cirrhosis, and hepatocellular carcinoma
- Ana Sayfa
- Sayılar
- Aralik 2018
- Kronik viral hepatitler, karaciger sirozu ve hepatosellüler karsinomada inflamasyon göstergesi olarak neopterin...
Department of 2Gastroenterology, Istanbul Memorial Atasehir Hospital, Istanbul, Turkey
Department of 3Gastroenterology, University of Health Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital,Istanbul, Turkey
Department of 4Gastroenterology, Kirikkale University School of Medicine, Kirikkale, Turkey
Özet
Giris ve Amaç: Neopterin hücre aracili immünitede rol oynayan proinflamatuvar bir belirleyicidir ve konsantrasyonu vücut sivilarindaki? interferonun varligini gösterir. Viral etiyolojili karaciger hastaligi olan kronik hepatit, karaciger sirozu, hepatosellüler kanserli olgularda, inaktif hepatit B virüsü tasiyicisi olanlarda neopterin seviyesini saptamak ve kontrol grubu ile karsilastirarak; viral etiyolojili kronik karaciger hastaliklarinda yeri olabilecek bir belirteç olabilecegini ispatlamak amaciyla bu çalisma planlandi. Gereç ve Yöntem: Çalismaya toplam 110 kisi (42 kadin, 68 erkek, yas ortalamasi 44±8.90) alindi. Bunlardan 33 hasta kronik hepatit, 22’si karaciger sirozu, 22’si hepatoma, 18’i inaktif hepatit B tasiyicisi ve 15’i saglikli kontrol grubu olarak belirlendi. Neopterin dü- zeyleri kronik hepatitli hastalarda interferon tedavisinden önce ve sonra ölçüldü. Gruplar arasindaki ölçümler istatistiksel olarak Mann-Whitney testiyle arastirildi. p<0,05 istatistiksel olarak anlamli kabul edildi. Bulgular: Cinsiyet ve neopterin düzeyleri arasinda istatistiksel olarak iliski saptanmadi. Hastaliklar degerlendirildiginde, neopterin seviyeleri siroz, hepatosellüler kanser, kronik hepatit grubundaki hastalarda saglikli ta- siyici ve saglikli kontrol grubundaki hastalara göre istatistiksel olarak anlamli düzeyde yüksekti. Neopterin düzeyleri, bu hasta gruplarinda aktivite göstergeleri olan aspartat aminotransferaz, alanin aminotransferaz, hepatit B virüs deoksiribonükleik asit, hepatit C virüs ribonükleik asit, sedimentasyon ve C-reaktif protein degerleri ile arasinda pozitif korelasyon vardi ve yüksek olarak saptandi. Interferon tedavisi sonrasi de- gerlendirilen 14 hastada ise tedaviye cevap alinmasina ragmen, neopterin düzeyleri ile aktivite belirteçleri arasinda anlamli iliski saptanmadi. Sonuç: Sonuç olarak neopterin seviyeleri inflamasyonu olan hastalarda saglikli kontrol ve inflamasyon aktivitesi beklenmeyen hepatit B tasiyi- cilarina göre anlamli olarak daha yüksekti. Interferon tedavisi verilen ve tedaviden fayda gören hastalarda hepatit B virüs deoksiribonükleik asit ve hepatit C virüs ribonükleik asit düzeyleri ile neopterin arasinda bir korelasyon saptanmadi. Neopterin seviyesi kronik hepatit, karaciger sirozu ve hepatosellüler kanserli olgularda inflamasyon aktivitesini gösterirken bunun klinik pratikteki yarari konusunda ilave çalismalara gerek oldugu açiktir.
Abstract
Background and Aims: Neopterin is a proinflammatory indicator that plays a role in cell-mediated immunity, and elevated concentrations of neopterin indicate the presence of interferon-? in body fluids. In this study, neopterin concentrations were determined in patients with a virus-induced chronic liver disease (chronic hepatitis, liver cirrhosis, and hepatocellular cancer), inactive hepatitis B virus carriers, and in a healthy control group to assess whether neopterin can be used as a disease marker in patients with virus-induced chronic liver disease. Materials and Methods: A total of 110 subjects (42 females and 68 males, with an average age of 44±8.90 years) were included in this study. Of these patients, 33 had chronic hepatitis; 22, liver cirrhosis; 22, hepatoma; 18, inactive hepatitis B virus carriers; and 15 were included in the healthy control group. Neopterin levels were measured before and after interferon treatment in patients with chronic hepatitis. Data collected among the groups were analyzed statistically using the Mann-Whitney test, considering p < 0.05 as statistically significant. Results:Neopterin concentrations and gender showed no statistically significant correlation. Patients with cirrhosis, hepatocellular cancer, and chronic hepatitis had statistically significantly higher neopterin levels than the healthy control and healthy carrier groups. A positive correlation was observed between neopterin levels and other disease activity indicators such as aspartate transaminase, alanine transaminase, hepatitis B virus deoxyribonucleic acid, hepatitis C virus ribonucleic acid, erythrocyte sedimentation rate, and C-reactive protein levels, and their levels were also high. Although 14 patients, who were also evaluated after interferon treatment, showed good response to the treatment, no statistically significant correlation was observed between their neopterin levels and disease activity indicator levels. Conclusion: Neopterin concentrations were found to be significantly higher in patients with inflammation than in inactive hepatitis B virus carriers who had no ongoing inflammatory activity and in the healthy control group. No correlation was detected between neopterin levels and hepatitis B virus deoxyribonucleic acid and hepatitis C virus ribonucleic acid levels in patients who received interferon treatment and benefitted from it. Although neopterin levels indicate inflammatory activity in cases of chronic hepatitis, liver cirrhosis, and hepatocellular cancer, additional studies are necessary to determine its usefulness in clinical practice.
