ارتباط مستوى متعدد السكريد الدهني في المصل مع الانترلوكين-1 والانترلوكين -10مع شدة مرض التهاب الكبد الفيروسي نوع بي وسي مع تشمع الكبد

The Association of Serum Levels of Bacterial LPS with IL -1and IL-10 in the Disease Severity of Hepatitis Viral Infections (HBV, HCV) and Liver Cirrhosis

Abstract

Viral hepatitis, which is an infection of the liver that results in its inflammation and damage, has been considered as global health problem for a very long time and is still regarded as a serious threat to human health. Hepatitis B virus (HBV) and Hepatitis C virus (HCV) can cause both acute and chronic infections.

Cirrhosis is an important cause of morbidity and mortality among patients with chronic liver disease. The major etiologies of cirrhosis are HBV and HCV infections. Globally, among individuals with cirrhosis, 42% had an HBV infection and 21% had an HCV infection.

It has been documented that as liver disease progresses, its ability to perform immune functions becomes impaired, allowing greater translocation of gut-derived microbes into systemic circulation and heightened susceptibility to systemic bacterial infections. Microbial products, such as lipopolysaccharide (LPS), is thought to be both a consequence of and promote liver disease progression.

There is limited information regarding the association between circulatory LPS and the level of some inflammatory and anti-inflammatory cytokines, the type of liver disease, and disease severity. Thus, the aim of the current study was association between bacterial LPS (as marker for bacterial translocation) and type of liver disease (HBV, HCV, and liver cirrhosis).

Across-sectional study was carried out at the College of Applied Medical Sciences/ Department of Clinical laboratories from the period 1 November 2022 to March 2023. Blood sample was collected from 89 patients with HBV, HCV, liver cirrhosis to be used in LPS, IL-1, and IL-10 measurement by ELISA technique.

Out of 45 (50.56%) of patients were infected with HBV, 21 (23.59%) infected with HCV and 23 (25.84%) with liver cirrhosis, the mean age of the patients with HBV, HCV, and Liver cirrhosis were 39.84±16.823, 42.76±15.59, and 49.87±15.9 respectively. Significant difference was noticed between mean age of HBV and Liver cirrhosis. The highest frequency of HBV, HCV, and cirrhosis was noticed within age range between 20-39 years old. More than 75% of patients were suffer from chronic diseases and a significant difference in the mean age of acute and chronic infection was observed.

No significant difference among the three studies groups were noticed according to Sex with M/F Ratio (29/16,1.8), (12/9,1.3), (10/13, 0.76) for HBV, HCV, and Liver cirrhosis respectively.

The current study revealed a significant decrease in the mean levels of LPS, IL-1, and IL-10 between HBV and the other two study groups. Also, a positive significant correlation between LPS, IL-10, and IL-1 among the three studied groups of patients.

Regarding diseases chronicity, the current study revealed that there were no significant differences in LPS, IL-1, and IL-10 levels according to disease duration. However, the mean level of LPS, IL-1, and 1L-10 were higher during the first year of the disease and the mean were higher in acute HBV than chronic HBV.

This study indicated that there were, no significant variations in the mean levels of ALT, AST, ALK, PT, and TSB among HBV with HCV and liver cirrhotic patients.

Approximately 53.5%, 33.3%, and 55.5% of HBV, HCV, and liver cirrhosis patients had an AST/ALT ratio greater than 1. Also, there was a significant positive correlation between LPS, IL-1, and IL-10 and alkaline phosphatase.

The significantly lower mean of LPS, IL-1, and IL-10 in HBV infected patients reflects the impact of HBV or its component in manipulating the inflammatory immune response during infection, which impedes pathogen clearance and results in persistent infection. A significant correlation between LPS and IL-10 and IL-1 indicated that LPS might possibly induce and amplify the inflammatory response among the studied groups.