El-Sheikh Ranya M, Mansy Soheir S, Nessim Iris G, Hosni Hala N, El Hindawi Ali, Hassanein Moataz H, AbdelFattah Ahmed S
Electron Microscopy Research Department (Pathology), Theodor Bilharz Research Institute, Giza, Egypt.
Clinical Chemistry Department, Theodor Bilharz Research Institute, Giza, Egypt.
APMIS. 2019 Feb;127(2):93-105. doi: 10.1111/apm.12917.
This study aims to assess the value of carbamoyl phosphate synthetase 1 (CPS1), as a non-invasive serum marker, for the evolution of chronic HCV infection and hepatic fibrosis. Seventy-two patients with HCV positive serum RNA and 15 health volunteers were enrolled in this study. Out of 72 patients, 10 patients had decompensated liver with ascites. Quantitative analysis of CPS1 was performed in the harvested sera and corresponding liver biopsies using ELISA and immunohistochemistry techniques respectively. Also, mitochondrial count using electron microscopy, urea analysis and conventional liver tests were done. Patients were grouped into (F1 + F2) and (F3 + F4) representing stages of moderate and severe fibrosis respectively. Tissue and serum CPS1 (s.CPS1) correlated significantly in moderate and severe fibrosis. Patients with severe fibrosis showed significantly higher levels of s.CPS1 (p-value ≤ 0.05) and significantly lower mitochondrial counts (p-value = 0.0065) than those with moderate fibrosis. S.urea positively correlated with s.CPS1 only in the decompensated group, at which s.urea reached maximal levels. In conclusion, s.CPS1 is a potential non-invasive marker for the assessment of severity and progression of HCV in relation to mitochondrial dysfunction. Also, increased s.urea with the progression of the disease is mainly due to a concurrent renal malfunction, which needs further investigation.
本研究旨在评估氨甲酰磷酸合成酶1（CPS1）作为一种非侵入性血清标志物，在慢性丙型肝炎病毒（HCV）感染及肝纤维化进展中的价值。本研究纳入了72例血清RNA HCV阳性患者和15名健康志愿者。72例患者中，10例为失代偿期肝硬化伴腹水患者。分别采用酶联免疫吸附测定（ELISA）和免疫组织化学技术对采集的血清及相应肝组织活检标本进行CPS1定量分析。此外，还进行了电子显微镜下线粒体计数、尿素分析及常规肝功能检查。患者被分为分别代表中度和重度纤维化阶段的（F1 + F2）组和（F3 + F4）组。在中度和重度纤维化中，组织和血清CPS1（s.CPS1）显著相关。重度纤维化患者的s.CPS1水平显著高于中度纤维化患者（p值≤0.05），线粒体计数显著低于中度纤维化患者（p值 = 0.0065）。仅在失代偿组中，血清尿素（S.urea）与s.CPS1呈正相关，此时S.urea达到最高水平。总之，s.CPS1是评估HCV严重程度及与线粒体功能障碍相关进展的潜在非侵入性标志物。此外，随着疾病进展S.urea升高主要归因于并发的肾功能不全，这需要进一步研究。
