Research & Development Department, Biotechnology Research Center, New Damietta City, Egypt.
Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Egypt.
Ann Hepatol. 2018;17(4):569-576. doi: 10.5604/01.3001.0012.0918.
The correlation between interleukin-28B (IL-28B) polymorphisms and chronic hepatitis C (CHC) progression is debatable. Here, we aimed to evaluate the relation between IL-28B C/T genotypes and the development of cirrhotic liver. Extracellular matrix (ECM) proteins, FibroScan and model for end-stage liver disease (MELD) were used to substantiate the severity of liver disease.
IL-28B rs12979860, liver stiffness and ECM proteins were assessed in 272 CHC patients.
Cirrhosis percentage increased to 10%, 52% and 96% with the increasing number of T alleles (CC, CT and TT, respectively). Also, elevated ECM proteins levels were correlated with the increasing number of T alleles. Interestingly, among cirrhotic patients, liver stiffness, MELD and ECM proteins were significantly (P < 0.0001) higher in patients with TT more than CT genotype. FibroScan, hyaluronic acid, Laminin, Collagen IV and the N-terminal pro-peptide of collagen type III have high accuracy to differentiate liver status in CC from TT genotype. Area under receiver-operating characteristic curve (95% CI) were 1.0 (1.0-1.0), 0.97 (0.96- 1.0), 0.93 (0.85-1.0), 0.98 (0.97-1.0) and 0.93 (0.91-0.97), respectively.
This study suggests that IL-28B T allele affects the natural course of CHC type 4 and also suggests that carriage of the IL-28B C allele protects from unfavorable clinical outcomes in CHC as coexistence of C allele with T allele reduced cirrhosis severity.
白细胞介素 28B(IL-28B)多态性与慢性丙型肝炎(CHC)进展之间的相关性存在争议。在这里,我们旨在评估 IL-28B C/T 基因型与肝硬化肝脏发展之间的关系。细胞外基质(ECM)蛋白、FibroScan 和终末期肝病模型(MELD)用于证实肝病的严重程度。
在 272 例 CHC 患者中评估了 IL-28B rs12979860、肝硬度和 ECM 蛋白。
随着 T 等位基因(CC、CT 和 TT)数量的增加,肝硬化百分比分别增加到 10%、52%和 96%。此外,升高的 ECM 蛋白水平与 T 等位基因数量的增加相关。有趣的是,在肝硬化患者中,TT 基因型患者的肝硬度、MELD 和 ECM 蛋白明显高于 CT 基因型(P < 0.0001)。FibroScan、透明质酸、层粘连蛋白、IV 型胶原和 III 型胶原 N 端前肽对区分 CC 与 TT 基因型的肝状态具有较高的准确性。受试者工作特征曲线下面积(95%CI)分别为 1.0(1.0-1.0)、0.97(0.96-1.0)、0.93(0.85-1.0)、0.98(0.97-1.0)和 0.93(0.91-0.97)。
本研究表明,IL-28B T 等位基因影响 CHC 4 型的自然病程,并且携带 IL-28B C 等位基因可保护 CHC 患者免受不利的临床结局,因为 C 等位基因与 T 等位基因的共存降低了肝硬化的严重程度。