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العنوان
Assessment of the serum CD14 and TIMP-1 levels as noninvasive markers of liver fibrosis in chronic hepatitis C patients \
المؤلف
Deghedy, Asmaa Abd-elFattah.
هيئة الاعداد
باحث / أسماء عبد الفتاح دغيدي علي دغيدي
مشرف / ايمان محمد عبد العظيم
مشرف / ماجده كمال الدين عز
مشرف / أمين محمد عبد الباقي
تاريخ النشر
2018.
عدد الصفحات
244 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
Biochemistry
تاريخ الإجازة
3/12/2018
مكان الإجازة
جامعة عين شمس - كلية العلوم - الكيمياء الحيوية
الفهرس
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Abstract

The present study was conducted to analyze the association of serum CD14, TIMP-1 and TGF-β1 levels with the histological stages of fibrosis in hepatic tissue of HCV patients to be used as an alternative way to liver biopsy. The current study included eighty five (n=85) volunteers classified into two groups: group one included (n=15) of normal and healthy people served as control group, group two included (n=70) of untreated HCV patients with liver fibrosis (well compensated, Child A, Child–Pugh Classification). This group was divided into 4 subgroups according to the degree of fibrosis (F1, F2, F3, and F4). All patients, ages range between 40-56 years, were with clinical, biochemical and sonographical criteria of chronic liver disease (Child A), Non- obese (BMI <30), Positive serology for HCV antibody and HCV vireamia, Liver biopsy showing chronic hepatitis. All patients with other causes of liver disease (e.g. HBV, alcohol, autoimmunity or hemochromatosis ), HIV infection, or with severe internal diseases (e.g. cancer, ischemic heart disease, autoimmune disease) were excluded.
All patients were selected and diagnosed according to the committee of National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt. The purpose, nature and potential risks of the study was explained to all subjects and written consents were obtained before their participation. Approval was taken from the research committee of General Organization of Teaching Hospitals and Institutions.
To fulfill this aim, specific objectives were achieved. These objectives included studying the influence of the degree of liver fibrosis in HCV patients on other parameters from a biochemical point of view, comparing between direct and indirect blood markers for non-invasieve diagnosis of liver fibrosis.
Results of this work showed that:
1) WBCs count and hemoglobin were non-significantly changed in all HCV grups while platelets count showed significant decrease with the increase in degree of fibrosis compared to the control group.
2) Serum PT-INR showed significant changes in all HCV groups compared to control group.
3) Serum liver enzymes showed that, the liver was aggressively affected with the HCV infectoin. This was shown by the significant increase in AST, ALT and total bilirubin in all HCV groups compared to normal control group while there was a significant decrease in albumin in all HCV groups compared to normal control group.
4) Serum sCD14 showed a non-significant increase in F1 patients and a slight significant increase in F2 patients compared to normal subjects. This increase was augmented in parallel with the degree of fibrosis in F3, while a dramatic level was present in cirrhotic patients F4.
5) Serum level of TIMP1 was non-signigcantly increased in the chronic HCV patients with low degree of fibrosis (F1 and F2), conversely, a high significant increase was seen in extensive fibrosis for F3 and F4 respectively compared to control group.
6) Serum TGF-β1 and AFP revealed a significant increase in all HCV patients compared to normal control. Serum levels increased gradually with increased stage of fibrosis to reach its maximum level in cirrhotic patients.
7) Calculating Fib4 value showed high significantly increased in early fibrosis for F! and F2 respectively. This increasment was synergized in extensive fibrosis F3 and F4 respectively.
8) Calculating AAR value revealed a high significant increase in F1 and F2 respectively, this increase was augmented parallel to fibrosis progression F3 and F4 respectively.
Conclusion
In conclusion, due to the high incidence of HCV infection in Egyptian population, there was a great need to search for a more accurate non-invasive markers of direct blood markers rather than indirect markers (that include two or more parameters which increase the chance of error) to used for screening the progression of fibrosis.
Our data supported that, sCD14, TIMP-1 and TGF-B1 has high sensitivity and specifity for extensive stages of fibrosis (F3 and F4) and serum sCD14 was the most sensitive and specific non invasive marker for diagnosis and prognosis of extensive stages of fibrosis (F3 and F4).