HCV infection in haemodialysed patients: A role for serum IL-10 and TGF-beta(1) in liver damage?
March 29th, 2008 | by admin |HCV infection in haemodialysed patients: A role for serum IL-10 and TGF-beta(1) in liver damage?
BACKGROUND: Hepatitis C virus (HCV) infection is often clinically silent in haemodialysed (HD) patients and their immune response may modulate liver damage in HCV infection. IL-10 and TGF-beta(1) could play a role in this setting as, IL-10 down-regulates hepatic fibrosis, while TGF-beta(1) is a pro-fibrotic cytokine. AIM: To evaluate the role of IL-10 and TGF-beta(1) in HD/HCV+ patients. PATIENTS: 71 HD/HCV+ patients (58 with normal [HD/HCV-N] and 13 with high serum transaminases [HD/HCV-H]), 40 non-uremic patients with chronic hepatitis C (HCV+), 56 HD anti-HCV- patients and 20 healthy volunteers (H). METHODS: IL-10 and TGF-beta(1) serum levels were assessed using ELISA tests. Liver histology was assessed by Ishak\’s score. RESULTS: IL-10 serum levels were significantly higher in HD patients, both HCV+ (3.7+/-0.4pg/ml; p<0.01) and HCV- (3.8+/-0.8pg/ml; p<0.05) than in non-uremic HCV patients (2.3+/-0.4pg/ml). Among the HD/HCV+ patients, IL-10 serum levels were similar in HD/HCV-N and in HD/HCV-H patients. Among the HD/HCV+ patients, IL-10 serum levels were similar in those with moderate histological damage compared to those with mild damage. TGF-beta(1) serum levels were significantly lower in HD patients, both HCV+ (4.6+/-0.9ng/ml) and HCV- (6.0+/-0.9ng/ml) than in non-uremic HCV+ patients (8.1+/-1.1ng/ml; p<0.001 and p<0.01, respectively), but similar to the values found in H (5.3+/-0.9ng/ml; p=n.s.). No correlation was seen between IL-10 and TGF-beta(1) serum levels in any of the groups considered. CONCLUSIONS: Patients on haemodialysis treatment to have high levels of IL-10, which remain high even when patients are anti-HCV+, whereas the opposite is true of TGF-beta(1). The cytokine pattern observed in HD patients is compatible with the hypothesis explaining the relatively benign evolution of HCV-related liver disease in HD patients, and has a pathophysiological role.
Burra P, Masier A, Morisco F, Di Leo V, Zorzi M, Senzolo M, Marchini F, Guido M, Canova D, Floreani A, Burroughs AK.
Gastroenterology Section, Department of Surgical and Gastroenterological Sciences, University of Padova, via Giustiniani 2, 35128 Padova, Italy.