Serum Kallistatin Level as a Predictor of Esophageal Varices in Patients of Liver Cirrhosis

Abstract

Esophageal varices are porto-systemic collaterals resulting from portal hypertension, and considered the most lethal complication of liver cirrhosis. Kallistatin a tissue kallikrein-binding protein and a serine proteinase inhibitor, it is mainly formed in the liver and its serum level is diminished in liver cirrhosis. It has anti-angiogenic, anti-oxidant, anti-inflammatory and anti-tumor effects. Kallistatin level is believed by many literature to be related to the severity of liver disease. This study aimed to evaluate the value of serum Kallistatin as a non-invasive predictor of EVs. This study was conducted in the Gastro-enterology unit, Internal medicine department, Ain Shams University hospitals &Theodor Bilharz Institute. 60 cirrhotic patients and 20 healthy individuals were included. Serum Kallistatin level was measured for all participants using ELISA kit supplied by Cloud-Clone Corporation® USA. Serum Kallistatin level showed significant reduction in patients with liver cirrhosis as compared to healthy individuals. There was also a highly significant difference between patients with EVs and patients without EVs as regards serum Kallistatin level. Serum level of Kallistatin had no correlation with the size of varices or the risky signs of variceal bleeding.