RESUMEN
AIM OF THE STUDY: Deregulation of insulin-like growth factor I (IGF-I) production and decreased hepatic estrogen levels were associated with development of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) infected cirrhotic patients. The aim of our study was to determine serum levels of IGF-I, insulin and 17-ß estradiol (17-ßE) in relation to other markers of liver injury in chronic hepatitis C (CHC) patients. MATERIAL AND METHODS: Thirty anti-viral treatment-naïve CHC patients and 10 healthy subjects were examined. HCV infection was confirmed by presence of anti-HCV and HCV-RNA in serum. Serum levels of IGF-I, insulin and of 17-ßE were evaluated using ELISA methods. RESULTS: Serum levels of IGF-I and 17-ßE were significantly lower in CHC patients than in controls while insulin levels were similar in both groups. A lower IGF-I level (but not the level of 17-ßE) was observed in cirrhotic CHC patients in comparison to non-cirrhotic ones. Decreased serum level of IGF-I was associated with more advanced staging and liver steatosis, higher levels of alpha-fetoprotein (AFP) and gamma globulin levels, and higher aspartate transaminase (AST) activity in CHC patients. Insulin and 17-ßE levels positively correlated with patient's age. A positive correlation was observed between insulin level on one hand and staging, liver steatosis and levels of gamma globulins in CHC patients on the other. A negative correlation between IGF-I and insulin levels was noted only in HCV infected patients. CONCLUSIONS: Decreased IGF-I levels and increased levels of insulin better than estradiol serum levels characterize staging and liver steatosis in CHC patients. The lower serum level of 17-ßE in the CHC group than in control patients suggests that CHC patients carry higher risk of liver injury and of HCC development.
RESUMEN
Histological lesions of gallbladder were described mainly in older patients with cholelithiasis (CH). The aim of the study was to analyse morphological alterations in gallbladder mucosa and selected clinical data of young patients with CH. The studies were conducted on 57 patients with CH, subjected to cholecystectomy in the years of 2003-2007. In course of the years, 37 respective young patients (below 25 years of age) were operated. The comparative group included twenty 50-year-old patients with gallstones. The inflammatory activity (grading) was evaluated using a semiquantitative scale on HE-stained gallbladders. In either group, women with chronic cholecystitis and multiple gallstones prevailed. Histological alterations in young patients involved absence of evident epithelial metaplasia traits, low number of foamy cells and prevalence of eosinophils in gallbladder mucosa. Even if a similar grading in gallbladder walls was noted in young and older patients, only in the former ones, a higher grading was detected in patients with an acute clinical course of the gallstone disease. The results point also to a potential role of local accumulation of eosinophils in gallbladder mucosa in pathogenesis of CH in young patients.
Asunto(s)
Vesícula Biliar/patología , Cálculos Biliares/patología , Membrana Mucosa/patología , Adolescente , Adulto , Colecistectomía , Eosinófilos/patología , Femenino , Vesícula Biliar/cirugía , Cálculos Biliares/cirugía , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Cytokeratins (CKs) 8 and 18 are normally expressed in simple epithelia. This unique pair of CKs is believed to be involved in hepatic diseases and many human cancers. Little is known about the role of tissue expression of both CKs in patients with cholelithiasis (CH). The aim of the study was to analyse tissue expression of CK8 and 18 in the specimens of gallbladder mucosa in 35 young (up to 25 years of age) and 20 older patients (approximately 50 years of age) with CH. An immunocytochemical ABC method and the spatial visualization technique were conducted. Our study demonstrated significantly lower amounts of both CKs in young patients, as compared to older patients. The higher cellular expression of CK8 in older patients was linked to acute clinical course vs. chronic ones. Tissue expression of neither CK correlated with inflammatory activity (grading) of the gallbladder mucosa. A positive correlation between reciprocal expressions of the two CKs may confirm a cytoprotective role of the two proteins in both groups of patients with symptomatic CH. Significantly higher expression of CK18 than that of CK8 in younger patients suggests a different role of CK8 and 18 in lithogenesis in this group.
Asunto(s)
Colelitiasis/patología , Vesícula Biliar/patología , Queratina-18/metabolismo , Queratina-8/metabolismo , Enfermedad Aguda , Adolescente , Adulto , Factores de Edad , Biomarcadores/metabolismo , Colecistectomía , Colecistitis/complicaciones , Colecistitis/metabolismo , Colecistitis/patología , Colelitiasis/complicaciones , Colelitiasis/metabolismo , Enfermedad Crónica , Femenino , Vesícula Biliar/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Membrana Mucosa/metabolismo , Membrana Mucosa/patología , Adulto JovenRESUMEN
The study aimed at examination of tissue expression of polysaccharides and secretory mucin 5AC (MUC5AC) in young patients (up to 25 years of age) with a symptomatic gallstones. For comparison, patients most frequently subjected to cholecystectomy were studied, i.e. patients of approximately 50 years of age with the same diagnosis. In quantitative studies on tissue expression of both mucus components, the modern technique of spatial visualization was applied for the first time. Application of the technique permitted to demonstrate significant positive relationships between expression of glycoproteins (immunocytochemical ABC technique for detection of MUC5AC) and expression of sugar components in mucus (PAS technique) and to confirm suitability of the technique for quantitative appraisal of both histochemical and immunocytochemical reactions. An even higher expression of polysaccharides in the entire mucosa and of MUC5AC was detected in gallbladder epithelium of 50-year-old patients, as compared to young patients with symptomatic gallstones. In the young patients, expression of polysaccharides correlated with inflammatory activity (grading), width of gallbladder wall and PLT level in peripheral blood. A significantly higher expression of polysaccharides in gallbladder epithelium was demonstrated in young patients admitted in the emergency mode to the hospital. These correlations in young patients may suggest a role of both mucus components in pathogenesis of cholelithiasis in this age group. A quantitative appraisal of mucus component expression in the two parts of gallbladder mucosa (epithelium vs. entire mucosa) using spatial visualization technique permitted to more accurately compare production of glycoproteins and of polysaccharides in patients with cholelithiasis and to demonstrate additional correlations of a potential clinical significance.