Mehmedović Amila, Mesihović Rusmir, Prnjavorac Besim, Vanis Nenad, Vukobrat-Bijedić Zora, Borovac Nađa, Zubčević Nađa, Pilav Aida, Gornjaković Srđan, Kulo-Ćesić Aida, Mujarić Ekrema, Saray Aida
1 Department of Gastroenterology and Hepatology, Referral Centre for Gastrointestinal Endoscopy, Clinical Centre, University of Sarajevo, 2 Department of Pathophysiology, School of Pharmacy, University of Sarajevo; Sarajevo, 3 General Hospital Tešanj, Tešanj, 4 Institute of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Sarajevo, Sarajevo; Bosnia and Herzegovina, 5 Cantonal Hospital Zenica, Department of Internal Medicine.
Med Glas (Zenica). 2013 Feb;10(1):20-7.
To analyze the usefulness of specified immunological parameters, proinflammatory IL-1α and profibrogenic, antiinflammatory TGF-β1, along with routinely used laboratory tests, in the differential - diagnostic procedure of chronic hepatitis of infectious and noninfectious etiology.
A total of 150 subjects were divided into two groups, depending on the infectious or noninfectious etiology of liver damage, and the control group. Apart from standard laboratory tests, the analysis included serum levels of cytokines: IL-1α and TGF-β1.
A high degree of correlation of serum level of IL-1α with viral hepatitis has been found, especially with active replication of genetic material ( HBV-DNA or HCV-RNA-PCR positive), p less 0.01. The highest mean concentration of TGF-β1 was noted in the group of malignant and toxic hepatitis, p less 0.0001. A negative correlation between the concentration of IL-1α and TGF-β1 has been found (-0.18). For IL-1 α significant predictive parameters included a previous infection of hepatitis B, lower serum level of TGFβ, age, use of alcohol, lower MELD and Chilld-Pugh scores. For TGF-β1 significant predictive parameters were age, lower MELD and Child-Pugh scores, history of receiving transfusions, lower serum level of IL-1α, higher serum level of fibrinogen. A predictive model has been delivered MELD = (TGF-β1) x 0,001- (IL-1 α) x 0,085 + CTP x 1,771-2,052; ( ± 2.04, R2=0,61; p less 0,001).
Inflammatory and immune parameters, analyzed together could significantly contribute to the understanding of chronic liver damage and thus differential diagnostic procedure. IL-1α and TGF-β1 are important parameters of inflammatory activity and fibrosis evaluation in chronic liver damage.
分析特定免疫参数、促炎细胞因子白细胞介素-1α（IL-1α）和促纤维化、抗炎细胞因子转化生长因子-β1（TGF-β1）以及常规实验室检查在感染性和非感染性病因所致慢性肝炎鉴别诊断过程中的作用。
根据肝损伤的感染性或非感染性病因，将150名受试者分为两组，并设立对照组。除标准实验室检查外，分析还包括细胞因子IL-1α和TGF-β1的血清水平。
发现IL-1α血清水平与病毒性肝炎高度相关，尤其是与遗传物质的活跃复制（乙肝病毒脱氧核糖核酸或丙肝病毒核糖核酸聚合酶链反应阳性），P<0.01。在恶性和中毒性肝炎组中，TGF-β1的平均浓度最高，P<0.0001。已发现IL-1α浓度与TGF-β1浓度之间呈负相关（-0.18）。对于IL-1α，显著的预测参数包括既往乙肝感染、较低的TGFβ血清水平、年龄、饮酒情况、较低的终末期肝病模型（MELD）和Child-Pugh评分。对于TGF-β1，显著的预测参数为年龄、较低的MELD和Child-Pugh评分、输血史、较低的IL-1α血清水平、较高的纤维蛋白原血清水平。已得出预测模型：MELD =（TGF-β1）×0.001 -（IL-1α）×0.085 + CTP×1.771 - 2.052；（±2.04，R2 = 0.61；P<0.001）。
一起分析炎症和免疫参数可显著有助于理解慢性肝损伤，从而有助于鉴别诊断过程。IL-1α和TGF-β1是慢性肝损伤中炎症活动及纤维化评估的重要参数。
