RESUMO
Liver biopsy is the gold-standard method to stage fibrosis; however, it is an invasive procedure and is potentially dangerous. The main objective of this study was to evaluate biological markers, such as cytokines IL-13, IFN-gamma, TNF-alpha and TGF-beta, platelets, bilirubins (Bil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total proteins, gamma-glutamil transferase (gamma-GT) and alkaline phosphatase (AP), that could be used to predict the severity of hepatic fibrosis in schistosomiasis and hepatitis C (HC) as isolated diseases or co-infections. The following patient groups were selected: HC (n = 39), HC/hepatosplenic schistosomiasis (HSS) (n = 19), HSS (n = 22) and a control group (n = 13). ANOVA and ROC curves were used for statistical analysis. P < 0.05 was considered significant. With HC patients we showed that TNF-alpha (p = 0.020) and AP (p = 0.005) could differentiate mild and severe fibrosis. With regard to necroinflammatory activity, AST (p = 0.002), gamma-GT (p = 0.034) and AP (p = 0.001) were the best markers to differentiate mild and severe activity. In HC + HSS patients, total Bil (p = 0.008) was capable of differentiating between mild and severe fibrosis. In conclusion, our study was able to suggest biological markers that are non-invasive candidates to evaluate fibrosis and necroinflammatory activity in HC and HC + HSS.
Assuntos
Biomarcadores/sangue , Hepatite C/sangue , Cirrose Hepática/sangue , Hepatopatias Parasitárias/sangue , Esquistossomose/sangue , Esplenopatias/sangue , Adolescente , Adulto , Idoso , Análise de Variância , Estudos de Casos e Controles , Hepatite C/complicações , Hepatite C/patologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/patologia , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/patologia , Pessoa de Meia-Idade , Necrose/patologia , Curva ROC , Esquistossomose/complicações , Esquistossomose/patologia , Índice de Gravidade de Doença , Esplenopatias/complicações , Esplenopatias/patologia , Adulto JovemRESUMO
Liver biopsy is the gold-standard method to stage fibrosis; however, it is an invasive procedure and is potentially dangerous. The main objective of this study was to evaluate biological markers, such as cytokines IL-13, IFN-ã, TNF-á and TGF-â, platelets, bilirubins (Bil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST), total proteins, ã-glutamil transferase (ã-GT) and alkaline phosphatase (AP), that could be used to predict the severity of hepatic fibrosis in schistosomiasis and hepatitis C (HC) as isolated diseases or co-infections. The following patient groups were selected: HC (n = 39), HC/hepatosplenic schistosomiasis (HSS) (n = 19), HSS (n = 22) and a control group (n = 13). ANOVA and ROC curves were used for statistical analysis. P < 0.05 was considered significant. With HC patients we showed that TNF-á (p = 0.020) and AP (p = 0.005) could differentiate mild and severe fibrosis. With regard to necroinflammatory activity, AST (p = 0.002), ã-GT (p = 0.034) and AP (p = 0.001) were the best markers to differentiate mild and severe activity. In HC + HSS patients, total Bil (p = 0.008) was capable of differentiating between mild and severe fibrosis. In conclusion, our study was able to suggest biological markers that are non-invasive candidates to evaluate fibrosis and necroinflammatory activity in HC and HC + HSS.
Assuntos
Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Biomarcadores/sangue , Hepatite C/sangue , Cirrose Hepática/sangue , Hepatopatias Parasitárias/sangue , Esquistossomose/sangue , Esplenopatias/sangue , Análise de Variância , Estudos de Casos e Controles , Hepatite C , Hepatite C/patologia , Cirrose Hepática , Cirrose Hepática/patologia , Hepatopatias Parasitárias , Hepatopatias Parasitárias/patologia , Necrose/patologia , Curva ROC , Índice de Gravidade de Doença , Esquistossomose , Esquistossomose/patologia , Esplenopatias , Esplenopatias/patologiaRESUMO
The production and regulation of interleukin (IL) IL-13, IL-4 and interferon-gamma was evaluated in different clinical forms of human schistosomiasis. The mechanisms of immune regulation are apparently different in the various clinical stages of the disease, some of them being antigen specific