Плазмовий остеопонтін як біомаркер фіброзу печінки у дітей з хронічним гепатитом В
Journal Title: Гепатологія - Year 2018, Vol 39, Issue 1
Abstract
13 было определение уровня плазменного остеопонтина (ОПН) у детей, в зависи- мости от вирусной нагрузки, активности воспалительного процесса и степени фиброза в печени. Установлено, что уровень данного гликопептида у детей с ХГВ на фоне ОЛЛ достоверно выше, чем у больных с ХГВ и здоровых (р<0,05). Независимо от вирусной нагрузки, активности процесса и степени фиброза су- щественно более высокие значения ОПН обнаружены именно у детей с ХГВ на фоне ОЛЛ, чем у остальных обследованных. Кроме того, у большинства детей данной группы диагностированы фибротические изменения (F1-F3) с различ- ной активностью некровоспалительного процесса в печени (А0-А3). У больных с ХГВ на фоне ОЛЛ уровень плазменного ОПН положительно коррелирует со степенью фиброза и активностью печеночного воспаления (р<0,05). Таким об- разом, остеопонтин является важным компонентом внеклеточного матрикса, который способствует фиброзу печени и может считаться новым неинвазивным биомаркером его тяжести у детей с хроническим гепатитом В. Ключевые слова: хронический гепатит В, дети, лимфобластный лейкоз, фи- броз, остеопонтин PLASMA OSTEOPONTIN AS A BIOMARKER OF LIVER FIBROSIS IN CHILDREN WITH CHRONIC HEPATITIS B I.I. Nezgoda, L.V. Moroz, S. Singh, O.O. Singh Vinnitsa National Medical University named aft er M.I. Pirogov, Vinnytsya, Ukraine Th e article presents the results of 71 children with chronic viral hepatitis B (CHB) aged 3 to 17 years, of them 41 cases of hepatitis were with acute lymphoblastic leukemia (ALL) (main group) and the control group included 20 healthy children. Th e aim of the study was to determine the level of plasma osteopontin (OPN) in children, depending on the viral load, intensity of infl ammatory activity and the degree of fi brosis in the liver. According to the results, the level of this glycopeptide in CHB children with ALL (248,20 [185,18-408,72] ng/ml) is signifi cantly higher than in patients of comparison group with CHB (119,45 [76,50-193,45] ng/ml) and in healthy children (94.50 [74.55-115.0] ng/ml) (p<0.05). In the main group, the level of OPN was signifi cantly higher in patients with low viral load (208.06 [185.18-327.53] ng/ml) and high viral load (250.38 [182.47-472.52] ng/ml) compared to healthy children (p<0,05). As a result of the study, it was found that only 13 children (31.7%) with CHB and ALL had no liver fi brosis, whereas more than half of these patients (68.24% (28)) were with various degrees of liver fi brosis, from F1 to F3. It should be noted that minimum level of OPN was observed in children without liver fi brosis in the main group (185.18 [79.72-215.62] ng/ml) as well as in the comparison group (81.57 [65.62-90.18], ng/ml); and with the increase in degree of fi brosis, the plasma OPN levels also increased. In patients from the main group with F3, the level of OPN (472.52 ng/ml) was signifi cantly higher than with F1 (216.23 [196.80-258.25] ng/ml) (p<0.05). In the patients with liver fi brosis F2 (490.23 [408.72-500] ng/ml), the level of OPN was signifi cantly higher than in children with F1 (p<0.05). A similar pattern was also observed in children of the comparison group (p<0.05). Consequently, during the assessment of OPN levels in the main group and the comparison group, it was found that this index is higher in all CHB patients with ALL as compared with the control group (children with CHB). While absolute certainty was signifi cantly higher in the patients with F2. As per the degree of infl ammatory activity, it was found that the vast majority of children, 56.66% (17 patients) with CHB recovered without infl ammatory processes in the liver, whereas only 14.64% (6 patients) of CHB patients with ALL did. In general, 85.36% (35 children) belonging to this category had a pathological process in the liver accompanied by non-infl ammatory activity with the degrees ranging from A1 and A3. On assessment of plasma OPN level in both groups, it was found that the degree of infl ammatory activity was higher in patients of the main group in the survey. Among the patients with infl ammatory activity A1, the level of OPN was signifi cantly higher (p<0.05) in CHB patients with ALL (232.73 [220.22-500.0] ng/ml) than in the patients with CHB (156.20 [113.60-196.60] ng/ml). Based on correlation analysis, a direct correlation between the level of OPN, the stage of fi brosis and the infl ammatory activity were determined in both study groups. Th us, with the increase in the degree of liver fi brosis, the level of plasma OPN in patients of the main group (r = 0.721, p<0.001) and the comparison groups (r = 0.769, p<0.001) increases. A similar positive correlation was found between the level of OPN and non- infl ammatory activity in the liver of CHB patients with ALL (r = 0.63, p<0.001) and CHB (r = 0,55, p<0.001). Th e data we have received coincide with the data of foreign literature. Osteopontin is an important component of the extracellular matrix that promotes liver fi brosis and can be considered as a new non-invasive biomarker for its severity in children with chronic hepatitis B.
Authors and Affiliations
I Nezgoda, L Moroz, S Singh, O Singh
Keywords
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