Comparison between Level of Serum Pentraxin3 in Non-Alcoholic Fatty Liver Patients with or without Hepatitis C Virus

Abstract

Summary N onalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver injury in many countries around the world.It represents a spectrum of conditions that histologically characterized by macrovesicular hepatic steatosis. The histological changes range over a wide spectrum, extending from simple steatosis,which is generally non-progressive,to NASH, liver cirrhosis, liver failure, and sometimes even HCC. Liver biopsy represents the best diagnostic test for staging liver steatosis, inflammation and fibrosis, but medical and ethical considerations limit its use in subjects with non progressive fatty liver conditions. PTX3 is an acute phase protein expressed locally in response to a variety of infectious and inflammatory responses involved in the innate immunity and inflammation. A long pentraxin, PTX3, is produced by vascular cells or inflammatory cells and released into the circulation, possibly reflecting local inflammation in the liver. Plasma PTX3 levels might be a potentially useful biomarker for diagnosis as well as to detect inflammatory status in patients with NAFLD. HCV infection is a widely spread disease allover the world and as recorded by the WHO, Egypt has the highest worldwide prevalence of HCV.About 80-85% of HCV patients progress to chronicity with further complications such as fibrosis, cirrhosis or HCC. This study aimed to evaluate and compare plasma level of PTX3 in patients of non-alcoholic fatty liverand between patients of non-alcoholic fatty liver with positive hepatitis C infection. Plasma PTX3 level was measured in three groups collected from Gastroenterology Unit, Internal Medicine Department, Ain Shams University and Ismailia General Hospitals:  Group (1): 25 patients of non-alcoholic fatty liver diagnosed by ultrasonography and negative hepatitis C antibody.  Group (2): 25 patients of non-alcoholic fatty liver diagnosed by ultrasonography and with positive hepatitis C infection by PCR.  Group (3): 20 healthy control subjects. All subjects included in this study were subjected to full history taking, clinical examination, abdominal ultrasound and the following laboratory tests fasting and postprandial blood glucose, ALT, AST, serum creatinine, blood urea, lipid profile, complete blood count, serum albumin, serum total bilirubin, hepatitis C virus antibody, hepatitis C polymerse chain reaction (PCR) for positive hepatitis C virus antibody and hepatitis B surface antigen (HBsAg). Concentration of different markers were compared between the three groups to reveal significant markers in assessment of three groups. In conclusion, plasma PTX3 significantly increased in non-alcoholic fatty liver patients compared to healthy control subjects. Moreover, there was no significant difference in plasma PTX3 with or without HCV infection in non-alcoholic fatty liver patients.