Correlation of Serum Neopetrin as an Inflammatory Marker to Different Stages of Liver Cirrhosis

Abstract

Chronic liver diseases and their complications constitute a major health problem all over the world and especially in our country. Most of the morbidity and mortality of chronic liver diseases is due to its progression to cirrhosis and complications of cirrhosis. The underlying immunological response of chronic liver disease has usually been acting for months or years where inflammation and tissue repairing are in progress simultaneously which leads in the end to fibrosis and cirrhosis. According to WHO, liver cirrhosis accounted for 1.8% of all deaths in Europe, causing around 170, 000 deaths per year. Neopterin is an unconjugated low molecular weight pteridine produced by human and primate monocyte /macrophages upon activation by pro inflammatroy stimui like cytokines, tumer necrosis factor and interferon-gamma. Serum Neopterin levels are used as a marker of inflammation associated with cell-mediated immunity in various diseases thus may be used to monitor cellular immune activation in these diseases. Some studies reported that there is a correlation between serum levels of Neopterin and chronic liver disease especially those with advanced liver cirrhosis. Also, revealed that it`s much higher in patients with cirrhosis than in healthy individuals. Other studies found that Neopterin levels are high in sera of patients with liver cirrhosis child B. This study was designed to assess the association between elevated levels of Serum Neopetrin and Liver cirrhosis, also to explore the association between serum level of Neopterin in liver diseased patient with liver cirrhosis classified according to MELD score, and Child pugh classification. It was held in Gastroentrology and hepatology departement, Maadi Military Hospital. For better assessment, this study included number of (65) cases. They were divided into main four groups; Group I; formed of 15 patients post heatitic HCV liver diesase child A and Group II; formed of 15 patients post-hepatitic HCV liver disease Child B. and Group C; formed of 15 patients diagnosed as decompansated post-hepatitic HCV liver cirrhosis Child C Group D; formed of 20 individual as controllers All the studied cases were subjected to the following: careful medical history taking, full physical examination, and laboratory investigations including CBC, liver function tests, coagulation profile and serum neopterin. Abdominal