Hepatitis Monthly
Year:2018 | Volume:18 | Issue:4|Papers Count:5

It has been suggested that insulin resistance may play a role in pathogenesis of NASH, with hepatocyte apoptosis believed to be the main factor involved in disease progression from simple steatosis to NASH. During apoptosis, cytokeratin-18 (CK-18) is cleaved by caspases and released into serum, a finding that was shown to correlate with the existence of inflammation and fibrosis in patients with NASH. The present study aims to differentiate patients with simple steatosis from those with NASH using CK-18 assessment both in liver tissue and in serum. The present study was conducted on two groups of patients, the first including 44 patients with simple steatosis and the second comprising 106 patients with steatohepatitis. Serum fasting insulin was measured and serum CK-18 was estimated. No significant differences were found between steatohepatitis patients and patients with simple steatosis regarding fasting insulin levels, or HOMA-IR index (P > 0. 05 for each). Comparison of serum CK-18 levels between simple and advanced fatty liver patients showed significantly higher concentrations in patients with steatohepatitis than in patients with simple steatosis (P < 0. 001). Serum level of CK-18 demonstrated a satisfactory relationship with all pathological variables that allowed differentiation between both entities of nonalcoholic fatty liver disease.

Background: Cytokeratin-18 Neoepitope M30 (CK-18 M30) has been reported to be associated with chronic HBV infection and severity of liver injury; however, the results of these studies are inconsistent. Objectives: We sought to investigate the association between serum CK-18 M30 levels and the severity of liver injury in chronic hepatitis B (CHB) patients. Methods: A systematic literature search was performed in PubMed, Embase, and Cochrane Library databases for relevant studies published in English up to August 2017. Heterogeneity among individual studies was investigated for summarizing all the studies. The standard mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model or fixed-effects model. Finally, the sensitivity analysis and publication bias were performed to evaluate the accuracy of this meta-analysis. Statistical analysis was conducted using Review Manager 5. 3 and Stata 12. 0. Results: Five case-control studies were included in the ultimate analysis, recruiting 488 CHB patients, 276 inactive carriers, and 193 healthy controls. The major results of the meta-analysis revealed significantly elevated serum CK-18 M30 levels in chronic HBV infected patients includingCHBpatients with severe liver injury and inactive HBV carriers when compared to healthy controls (SMD = 1. 13, 95% CI: 0. 75-1. 50, P < 0. 001; SMD = 0. 63, 95% CI: 0. 38-0. 89, P < 0. 001, respectively). Furthermore, the serum CK-18 M30 levels were significantly higher in CHB patients with severe liver injury than in inactive carriers (SMD =1. 29, 95% CI: 0. 60-1. 98, P < 0. 001). The sensitivity and publication bias analysis verified the stability and reliability of our analysis. Conclusions: The elevated serum CK-18M30levels could be regarded as a useful non-invasive biomarker for the diagnosis of chronic HBV infection, and were associated with the severity of liver injury in chronic Hepatitis B patients. The serum CK-18 M30 levels could reflect the liver inflammation in inactive carriers, representing the early stage of chronic HBV infection.

Background: Hepatitis C Virus is the leading cause of death in liver-related diseases globally. The identification of innovative drug targets and inexpensive therapeutic agents remain a high priority for chronic HCV infection management. In the last few decades, the availability of highly effective interferon-free regimens for HCV treatment is the only possible option for cure of the large number of chronic HCV patients. Direct acting antiviral drugs, such as Sovaldi, are expensive and their efficacy varies from genotype to genotype. In addition, these drugs are advised in combination with ribavirin and interferon, which makes the treatment costly. Thiazolide derivatives are recently emerging antiviral agents that may change current and future therapies for liver complications caused by HBV and HCV. Nitazoxanides are synthetic nitrothiazolyl-salicylamide derivative of thiazolide, which have been used as anti-HCV drugs. The derivatives of thiazolides were randomly screened for anti-HCV and anti-HBV activity in a biological system, yet the stability and other properties of thesecompoundswere not tested. Representing chemicalcompoundswith Hosoya-polynomial produces closed forms of many topological indices, which correlate with the chemical properties of the material under investigation. These indices are used in the development of quantitative structure-activity relationships (QSARs), in which the biological activity and other properties of molecules like boiling point, stability, strain energy, radius of gyration, and viscosity are correlated with their structures. In this paper, Hosoya-polynomials and Weiner indices of some derivatives of thiazolides were determined. Graphs of Hosoya polynomial for these derivatives were also plotted. Objectives: In this study, therefore, it was attempted to extend the research to check the stability and other properties of thiazolide derivatives using the Hosoya-polynomial and Wiener index. Methods: In the first step, Hosoya polynomials of some famous classes of thiazolides were computed, followed by computation of F Wiener indices of thiazolide derivatives. Distance-based graph invariants were used as a structure-descriptor for predicting various physicochemical properties of organic compounds. The Weiner index of 8 derivatives of thiazolidines was computed, including RM-4832, RM-4848, RM-4850, RM-4851, RM-4852, RM-4850, Tizoxanide, and Nitazoxanide. Results: These indices indicate the physiochemical properties of these compounds in relation to stability in the given biological environment. The Wiener indices of the studied compounds ranged from 374 to 684. Out of 8 analyzed compounds, 3 showed Wiener indices of 374. RM-4863 had a maximum index value of 684. Graphs were also drawn for Hosoya polynomials of all these thiazole derivatives. Conclusions: The results confirmed that RM-4863 is a stable physiochemical compound, which might be used as an effective drug for treating viral infections, including HCV and HBV.

Background: The imbalance of T-helper (Th) lymphocyte cytokine production plays an important role in the immunopathogenesis of chronic Hepatitis B Virus (HBV) infection. Th1 cytokines are necessary for host antiviral immune response, while Th2 cytokines have an immunomodulatory role. Objectives: The current study aimed at determining the serum profile of Th1 and Th2 cytokines in patients with chronic HBV infection and to assess the correlation between the levels of the cytokines and ALT level in the patients. Methods: Sixty patients with chronic hepatitis B and 60 age and gender-matched healthy controls were enrolled in the study. The serum levels of Th1 cytokine, interferon gamma (IFN-), Th2 cytokines, IL-4, and IL-10 were measured using the enzyme linked immunosorbent assay (ELISA). The serum ALT level was measured by the Colorimetry method. Results: The results showed that the level of IL-4 was significantly lower in patients in comparison with the controls (P < 0. 05). However, the level of IL-10 was not significantly different in patients and healthy individuals (P > 0. 05). The concentration of IFN- was significantly higher in patients compared with the healthy controls (P < 0. 05). No significant correlation was found between serum levels of IL-4, IL-10 and IFN- and nor was it found between the levels of these cytokines and serum ALT level. Conclusions: The results revealed enhanced Th1 response and reduced Th2 response, which is favored for the formation of a strong immune response and leads to viral elimination. The decrease of IL-4 indicated a lower viral load in the patients. In addition, a non-active disease resulted from the patients’ IL10 level showing no significant difference between the patients and the controls. Significant increase of IFN- in patients indicated the activation of Th1 cells. The immunological outcome can help in finding better treatment strategies. The results suggest that interferon therapy with low dose can be a helpful strategy. Although the decrease in ALT level was not significantly correlated with an increase in IFN- in the patients, the increase of IFN- level demonstrated a modulation in hepatocellular damage.

Background: Hepatitis A virus (HAV) is a major cause of acute viral hepatitis throughout the world. The severity of HAV clinical symptoms in infected cases is related to age. Age-specific seroprevalence studies are a reliable method to estimate the susceptibility rate to HAV in populations and can help establish vaccination implementation policies. Objectives: In this studyweaimedto determine the age-specificHAVseroprevalenceamong1 to 23 years subjects residing in Tehran, Iran. Methods: In this cross-sectional study, blood samples of 1120 cases (516 male and 604 female) referred to hospitals’ biochemical laboratories in Tehran, Iran, between the ages of 1-23 years were tested for total hepatitis A antibody (anti-HAV) by ELISA. Stratification of the study population was conducted according to age. Results: The overall prevalence of total anti-HAV was 6% (95% CI: 4. 74%-7. 52%). HAV prevalence rates according to age groups were as follows: 5. 7% between 1-5 years, 1. 7% between 6-10 years, 4. 2% between 11-15 years, 5. 5% between 16-19 years, and 15. 3% between 20-23 years. Except the 6-10 year age group, an increase in HAV seropositivity was observed with age. Anti-HAV seropositivity in terms of age groups was significantly different from each other (P = 0. 000). The HAV seroprevalence rate was 32. 8% in males and 67. 2% in females with a significant difference between genders (P = 0. 025). Conclusions: Our study demonstrates that most young children are susceptible to HAV infection, whereas adolescents and young adults are at more risk for HAV acquisition. Therefore HAV vaccination of young children seems logic and beneficial.