Internal Medicine I Department, Gastroenterology, Hepatology, Endocrinology, Rheumatology and In-fectious Diseases, University Hospital Regensburg, Regensburg; Gastroenterology Department, Gemeinschaftsklinikum Mittelrhein, 56073 Koblenz, Germany. .
Internal Medicine I Department, Gastroenterology, Hepatology, Endocrinology, Rheumatology and In-fectious Diseases, University Hospital Regensburg, Regensburg; Internal Medicine Department, Klinikum Fürstenfeldbruck, 82256 Fürstenfeldbruck, Germany.
J Gastrointestin Liver Dis. 2022 Dec 17;31(4):444-452. doi: 10.15403/jgld-4341.
Serum galectin-3 is regarded as an inflammatory marker in patients with chronic liver diseases. Hepatitis C virus (HCV) infection is associated with higher levels of inflammatory molecules which ameliorate by efficient treatment with direct-acting antivirals (DAAs). The aim of this study was to compare serum galectin-3 levels between HCV patients before treatment with DAAs and at the time of sustained virologic response at 12 weeks post-treatment (SVR12).
Hepatitis B and human immunodeficiency virus-negative HCV infected patients not treated with HCV therapies before were recruited at the University Hospital of Regensburg. Galectin-3 was measured by enzyme-linked immunosorbent assay in the serum of patients with chronic HCV infection, before treatment initializing, at four and twelve weeks after the start of DAA therapy and at SVR12. Associations of serum galectin-3 with C-reactive protein (CRP), leukocyte count and measures of liver disease severity were analyzed. Liver fibrosis was assessed by acoustic radiation force impulse, the aspartate aminotransferase/platelet ratio index, and the fibrosis-4 score.
In the serum of 81 HCV patients, galectin-3 did not correlate with viral load, viral genotype, CRP, leukocyte count, or the model for end stage liver disease score. Therapy with DAAs effectively diminished viral load within four weeks in all patients. The median value of the serum galectin-3 was 3.0 (Q1:2.0, Q3:4.0) ng/ml before therapy and declined to 2.4 (Q1: 1.7, Q3: 3.4) ng/ml at SVR12 (p<0.001; paired samples of 67 patients). At SVR12, serum galectin-3 was not correlated with CRP (r=0.057, p=0.646) or leu-kocyte count (r=0.222, p=0.071) and did not change with increasing fibrosis stage. The associations between serum galectin-3 and body mass index, liver steatosis or diabetes could not be observed.
Elimination of HCV by DAA treatment lowered serum galectin-3 compared to the pre-treatment levels suggesting that HCV infection causes an increase of this immune-regulatory protein.
血清半乳糖凝集素-3（Galectin-3）被认为是慢性肝病患者的炎症标志物。丙型肝炎病毒（HCV）感染与炎症分子水平升高有关，而直接作用抗病毒药物（DAA）的有效治疗可改善这些炎症分子水平。本研究的目的是比较 DAA 治疗前和治疗后 12 周持续病毒学应答（SVR12）时 HCV 患者的血清 Galectin-3 水平。
在雷根斯堡大学医院招募了未接受 HCV 治疗的乙型肝炎和人类免疫缺陷病毒阴性的 HCV 感染患者。采用酶联免疫吸附试验（ELISA）检测慢性 HCV 感染患者治疗前、DAA 治疗开始后 4 周和 12 周及 SVR12 时的血清 Galectin-3 水平。分析血清 Galectin-3 与 C 反应蛋白（CRP）、白细胞计数和肝脏疾病严重程度指标的相关性。采用声辐射力脉冲技术、天门冬氨酸氨基转移酶/血小板比值指数和纤维化-4 评分评估肝纤维化。
在 81 例 HCV 患者的血清中，Galectin-3 与病毒载量、病毒基因型、CRP、白细胞计数或终末期肝病模型评分均无相关性。所有患者在 4 周内用 DAA 治疗均能有效降低病毒载量。治疗前血清 Galectin-3 的中位数为 3.0（Q1：2.0，Q3：4.0）ng/ml，SVR12 时降至 2.4（Q1：1.7，Q3：3.4）ng/ml（p<0.001；67 例患者配对样本）。SVR12 时，血清 Galectin-3 与 CRP（r=0.057，p=0.646）或白细胞计数（r=0.222，p=0.071）均无相关性，且不随纤维化分期增加而变化。未观察到血清 Galectin-3 与体重指数、肝脂肪变性或糖尿病之间的相关性。
与治疗前水平相比，DAA 治疗清除 HCV 可降低血清 Galectin-3，提示 HCV 感染可导致这种免疫调节蛋白增加。
