RANTES, TNF-α, Oxidative Stress and Hematological Abnormalities in Hepatitis C Virus Infection.

Document Type : Original Article

Authors

1 Department of Medical Biochemistry, Faculty of Medicine, Cairo University

2 Department of Clinical & Chemical Pathology, Faculty of Medicine, Cairo University

3 Department of Medical Biochemistry, Faculty of Medicine, October 6 University

4 Department of Internal Medicine, Faculty of Medicine, October 6 University

Abstract

Chronic infection with hepatitis C virus (HCV) is associated with failures of T-cell–
mediated immune clearance and with abnormal B-cell growth and activation.HCV
infection is characterized by a systemic oxidative stress that is most likely caused by a
combination of chronic inflammation, iron overload, liver damage, and proteins
encoded by HCV. Following viral infection, multiple pro-inflammatory mediators
contribute to recruitment of immune cells to the liver and to the generation of an antiviral
immune response. Recent publications mark chemokines and their receptors as
key players in leukocyte recirculation through the inflamed liver. The present study
involved 75 male subjects, included into two groups: Group1 (n=30) control group;
group II (n=45) patients with chronic HCV. For all subjects the following
investigations were performed: estimation of the levels of bilirubin, albumin,
prothrombin concentration, glycosylated hemoglobin (HbA1C), creatinine, α-
fetoprotein (AFP), HCV RNA, and activities of alanine and aspartate transaminases
(ALT& AST) as well as alkaline phosphatase. Also, Regulated on Activation Normal
T Cell Expressed and Secreted (RANTES), tumor necrosis factor alpha (TNF-α),
malondialdehyde (MDA) and nitric oxide (NO) were assessed. Plasma HCV-RNA
concentration (viral load) was determined by real time PCR step one using Applied
Biosystem. Complete blood picture was assayed using Abbott cell dyn 3700
hematology analyzer. There were significant increase of the levels of RANTES,TNF-
α, MDA and NO in HCV infected patients compared with control group (P <0.05)
and in these patients, these levels showed significant positive correlation with the
HCV RNA viral load. Also, mild leucopenia, thrombocytopenia, neutropenia,
lymphocytosis, with consequent significant increase in the lymphocytes / neutrophils
(L/N) ratio were detected in these patients.
Conclusion: The data support the concept of chemokines (RANTES) as mediators of
liver cell injury in hepatitis C infection. In addition, MDA and NO levels might be
used as monitoring markers for oxidative stress in hepatitis C infection.

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