MedInform

Journal of Medical and Dental Practice

www.medinform.bgISSN 2367-6795

Issue Two 2015

2015, Vol. 2, issue 2, (July)

Publisher: MedInform LTD
ISSN: 2367-6795
Pages: 147-200
Date of close: 2015/07/13

Original Article

Alpha-2 macroglobulin is the simplest serum biomarker for liver fibrosis and fibrogenesis in chronic hepatitis C

Abstract:

Systemic inflammatory response triggered by HCV per se and/or its subsequent immune cascades and acute phase inflammatory proteins may play a major role in it. In inflammatory or injured liver, the increase of A2MG inhibits catabolism of matrix proteins and thus causes liver fibrosis. Objective: 129 patients with chronic HCV infection were studied. All of them were candidates for combined treatment with pegylated interferon-alpha. Methods: Alpha 2 macroglobulin and haptoglobin levels were measured by immuno-turbidimetry. Serum concentrations of pro-hepcidin, hsCRP and TNF-alpha were measured by commercially available ELISA kits. Serum HCV RNA was quantified by using real-time PCR assay. Liver biopsy was obtained applying Menghini’s technique and was evaluated by METAVIR system. For non-invasive assessment of liver fibrosis and fibrogenesis we used specific scoring systems (APRI, FIB-4, SOS-FS and GAMAGEN).

Results: The mean A2MG level was significantly lower in subjects with A1 vs. A2 (p < 0,001) and A3 (p < 0,001). Patients with F3 stage of fibrosis were with higher mean A2MG level compared to those with F1 (p < 0.001) and F2 (p < 0.05). A2MG positively correlated with hepatic necro-inflammation (r= 0.433; p= 0.000) and fibrosis (r= 0.325; p= 0.000). A moderate positive correlation between A2MG and patient age is very important point as fibrosis rapidly progresses in elder patients.

Conclusion: A2MG is quite an informative serum biomarker that reflects liver fibrosis and fibrogenesis in chronic hepatitis C. It can be used in combination with haptoglobin, IgG and AST in scoring systems for non-invasive assessment of liver fibrosis and figrogenesis.

Authors:

Evelina Atanasova; Clinic of Gastroenterology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria;
Fani Martinova; Department of transfusion hematology and immunology, University Hospital “Pirogov”, Sofia, Bulgaria;
Deyan Jelev; Clinic of Gastroenterology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria;
Krassimir Antonov; Clinic of Gastroenterology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria;
Christian de Mey; ACPC – Applied Clinical Pharmacology Services, Mainz-Kastel, Germany;
Ludmila Mateva; Clinic of Gastroenterology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria;
Zahary Krastev ; Clinic of Gastroenterology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria;

Corresponding Author:

Evelina Atanasova; University Hospital “St. Ivan Rilski”, Clinic of Gastroenterology 1431 Sofia, Bulgaria; 15 “Acad. Ivan Geshov” blvd; +359 2 8510615; Email this author