查看更多>>摘要：AIM:To assess vitamin D (Vit D) abnormalities in hepatitis C infected patients and their relationship with interleukin (IL)-17,IL-23 and N-terminal propeptide of type Ⅲ pro-collagen (PⅢNP) as immune response mediators.METHODS:The study was conducted on 50 Egyptian patients (36 male,14 female) with hepatitis C virus (HCV) infection,who visited the Hepatology Outpatient Clinic in the Endemic Disease Hospital at Cairo University.Patients were compared with 25 age-and sexmatched healthy individuals.Inclusion criteria were based on a history of liver disease with HCV genotype 4 (HCV-4) infection (as new patients or under followup).Based on ultrasonography,patients were classified into four subgroups; 14 with bright hepatomegaly; 11 with perihepatic fibrosis; 11 with hepatic cirrhosis; and 14 with cirrhosis and hepatocellular carcinoma (HCC).Total Vit D (i.e.,25-OH-Vit D) and active Vit D [i.e.,1,25-(OH)2-Vit D] assays were carried out using commercial kits.IL-17,IL-23 and PⅢNP levels were assayed using enzyme linked immunosorbent assay kits,while HCV virus was measured by quantitative and qualitative polymerase chain reaction.RESULTS:Levels of Vit D and its active form were significantly lower in advanced liver disease (hepatic cirrhosis and/or carcinoma) patients,compared to those with bright hepatomegaly and perihepatic fibrosis.IL-17,IL-23 and PⅢNP levels were markedly increased in HCV patients and correlated with the progression of hepatic damage.The decrease in Vit D and active Vit D was concomitant with an increase in viral load,as well as levels of IL-17,IL-23 and PⅢNP among all subgroups of HCV-infected patients,compared to normal healthy controls.A significant negative correlation was evident between active Vit D and each of IL-17,IL-23 and PⅢ NP (r =-0.679,-0.801 and-0.920 atP ＜ 0.001,respectively).HCV-infected men and women showed no differences with respect to Vit D levels.The viral load was negatively correlated with Vit D and active Vit D (r =-0.084 and-0.846 at P ＜ 0.001,respectively),and positively correlated with IL-17,IL-23 and PⅢNP (r =0.951,0.922 and 0.94 at P ＜ 0.001,respectively).Whether the deficiency in Vit D was related to HCVinduced chronic liver disease or was a predisposing factor for a higher viral load remains to be elucidated.CONCLUSION:The negative correlations between Vit D and IL-17,IL-23 and PⅢNP highlight their involvement in the immune response in patients with HCV-4-related liver diseases in Egypt.
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