Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt, 12613.
J Clin Immunol. 2012 Dec;32(6):1262-9. doi: 10.1007/s10875-012-9727-7. Epub 2012 Jun 24.
Owing to the suggested role of osteopontin (OPN) in inflammation, autoimmunity and fibrosis, we investigated their serum concentrations in chronic hepatitis C virus (HCV) infected patients with and without autoimmune manifestations and correlated those levels to clinical manifestations and the histological severity of hepatic fibrosis. A total of 70 chronic HCV-infected patients (35 with and 35 without autoimmune rheumatic manifestations) were compared with 35 healthy volunteers matched for age and gender. Epidemiological, clinical, immunochemical and virological data were prospectively collected. OPN serum levels were assessed by an Enzyme Linked Immunosorbant Assay. The mean serum OPN levels were higher in HCV patients with autoimmune rheumatologic manifestations and in patients without; than that for the normal controls (p = 0.000). The mean OPN values progressively increased by increasing severity of liver fibrosis (p = 0.009). Multivariate analysis revealed that the presence of rheumatologic manifestations had the highest predictive value (b = 7.141, Beta = 0.414, p = 0.000) followed by liver fibrosis (b = 4.522, Beta = 0.444, p = 0.000) on the variation of OPN levels in our HCV patients. Among the group of patients with HCV and rheumatologic involvement, OPN serum levels were higher in patients with positive cryoglobulin and rheumatoid factor than in those without, and with systemic vasculitis than in those without. Correlation analysis didn't reveal any statistical significance of OPN with age, serum albumin, aminotransferases and viral load. Our data suggests OPN as a promising marker for HCV associated autoimmune rheumatologic involvement, particularly with regard to development of vasculitis and cryoglobinemia. In addition, it could serve as a biomarker to evaluate the severity of liver damages in HCV infected subjects.
由于骨桥蛋白(OPN)在炎症、自身免疫和纤维化中起作用,我们研究了其在慢性丙型肝炎病毒(HCV)感染患者中有无自身免疫表现的血清浓度,并将这些水平与临床表现和肝纤维化的组织学严重程度相关联。共比较了 70 例慢性 HCV 感染患者(35 例有自身免疫性风湿表现,35 例无自身免疫性风湿表现)和 35 名年龄和性别匹配的健康志愿者。前瞻性收集了流行病学、临床、免疫化学和病毒学数据。通过酶联免疫吸附试验评估 OPN 血清水平。有自身免疫性风湿表现的 HCV 患者和无自身免疫性风湿表现的患者的血清 OPN 水平均高于正常对照组(p=0.000)。血清 OPN 值随着肝纤维化程度的增加而逐渐升高(p=0.009)。多变量分析显示,风湿表现的存在具有最高的预测价值(b=7.141,β=0.414,p=0.000),其次是肝纤维化(b=4.522,β=0.444,p=0.000),这是影响我们 HCV 患者 OPN 水平变化的因素。在 HCV 合并风湿表现的患者中,血清 OPN 水平在有冷球蛋白和类风湿因子阳性的患者中高于无阳性的患者,在有系统性血管炎的患者中高于无血管炎的患者。相关性分析未发现 OPN 与年龄、血清白蛋白、氨基转移酶和病毒载量有任何统计学意义。我们的数据表明 OPN 是 HCV 相关自身免疫性风湿表现的一个有前途的标志物,特别是在血管炎和冷球蛋白血症的发生方面。此外,它还可以作为评估 HCV 感染患者肝损伤严重程度的生物标志物。