Department of Pediatric Hepatology, Menofiya University, Shebin El-koom, Menofiya, Egypt.
J Pediatr Gastroenterol Nutr. 2012 Mar;54(3):364-8. doi: 10.1097/MPG.0b013e31823e98c2.
Hepatitis C virus (HCV) infection is a serious health problem that causes chronic infection in up to 85% of cases. HCV nonstructural (NS) cysteine protease, NS2/3, is required for viral replication in vivo. Cystatin C is a naturally occurring cysteine protease inhibitor in human cells. We aimed to investigate the relation between serum levels of cystatin C and HCV viremia in treatment-naïve children with chronic hepatitis C.
Serum cystatin C levels were measured in 27 children with chronic hepatitis C and determined their relation with liver functions, histopathological parameters, and hepatitis C viral load. Serum cystatin C was compared with that of 25 age- and sex-matched healthy controls.
Cystatin C was significantly higher in patients than in controls (1.4 ± 0.47 vs 0.99 ± 0.49; P = 0.006), and in those with low viremia than in those with moderate viremia (1.55 ± 0.41 vs 0.99 ± 0.43; P = 0.013). Cystatin C was not correlated with histopathological findings in liver biopsy (P > 0.05 for all). In addition, there was no significant difference of cystatin C levels in patients with normal versus those with elevated transaminases (P > 0.05). Of importance, cystatin C correlated negatively with viral load (P < 0.0001).
Cystatin C levels correlated negatively with HCV viremia. This finding may reflect an inhibitory effect of cystatin C on HCV replication through inhibiting its NS2/3 and tempting for further studies for cystatin C as a possible adjuvant therapy for HCV infection.
丙型肝炎病毒(HCV)感染是一个严重的健康问题,在多达 85%的病例中会导致慢性感染。HCV 非结构(NS)半胱氨酸蛋白酶 NS2/3 是病毒在体内复制所必需的。胱抑素 C 是人类细胞中天然存在的半胱氨酸蛋白酶抑制剂。我们旨在研究初治慢性丙型肝炎儿童血清胱抑素 C 水平与 HCV 病毒血症之间的关系。
检测 27 例慢性丙型肝炎患儿的血清胱抑素 C 水平,并确定其与肝功能、组织病理学参数和丙型肝炎病毒载量的关系。将血清胱抑素 C 与 25 名年龄和性别匹配的健康对照者进行比较。
患者的胱抑素 C 明显高于对照组(1.4±0.47 与 0.99±0.49;P=0.006),且低病毒血症组高于中度病毒血症组(1.55±0.41 与 0.99±0.43;P=0.013)。胱抑素 C 与肝活检的组织病理学发现无相关性(所有 P>0.05)。此外,丙氨酸转氨酶正常和升高的患者胱抑素 C 水平无显著差异(P>0.05)。重要的是,胱抑素 C 与病毒载量呈负相关(P<0.0001)。
胱抑素 C 水平与 HCV 病毒血症呈负相关。这一发现可能反映了胱抑素 C 通过抑制其 NS2/3 对 HCV 复制的抑制作用,并促使进一步研究胱抑素 C 作为 HCV 感染的一种可能辅助治疗方法。