Ladero JM, Cárdenas MC, Ortega L, González-Pino A, Cuenca F, Morales C, Lee-Brunner A

Language: English
References: 16
Page: 648-651
PDF size: 84.00 Kb.

ABSTRACT

Background. Serum levels of cystatin C, an endogenous inhibitor of cysteine proteases, provide an alternative method to creatinine-based criteria for measuring glomerular filtration rate. Preliminary data suggested that serum cystatin C levels parallel with the stage of liver fibrosis in chronic liver disorders. Our aim has been to evaluate the possible role of serum cystatin C as a marker of liver fibrosis in hepatitis C virus (HCV)-induced chronic liver disease. Material and methods. 100 consecutive patients (56 men, mean age 51.2 ± 9.5 yrs) with HCV-induced chronic liver disease, scheduled for their first liver biopsy and naïve for antiviral therapy were included. Liver fibrosis was evaluated with the METAVIR score. Serum cystatin C and standard laboratory tests were measured simultaneously. Patients with ethanol abuse (› 50 g/day), HBV or HIV coinfection or plasma creatinine ≥ 1.20 mg/dL were excluded. In addition, a second group of 16 patients fulfilling the same requisites and diagnosed with HCV-induced compensated cirrhosis by clinical evidence of portal hypertension was included. Results. Serum cystatin C levels significantly increase from F0 to F2 fibrosis stages, remained stable in F3 and F4 stages and increased again in the group of non-biopsied compensated cirrhosis. Serum cystatin C levels were higher in patients with moderate-advanced necroinflammation in the liver biopsy. Conclusion. Serum cystatin C level may reflect current fibrogenic and necroinflammatory activities in chronic HCV-induced liver disease with normal renal function but can not be considered as a non-invasive marker of liver fibrosis.

REFERENCES

1. Kleiner DE. The liver biopsy in chronic hepatitis C: a view from the other side of the microscope. Semin Liver Dis 2005; 5: 52-64.

2. Gressner AM, Gao C-F, Gressner OA. Non-invasive biomarkers for monitoring the fibrogenic process in liver: A short survey. World J Gastroenterol 2009; 15: 2433-40.

3. Ladero JM. Noninvasive evaluation of liver fibrosis in patients with chronic hepatitis C. Hepat Mon 2011; 11: 698-700.

4. Randers E, Erlandsen EJ. Serum cystatin C as an endogenous marker of the renal function-a review. Clin Chem Lab Med 1999; 37: 389-95.

5. Francoz C, Glotz D, Moreau R, Durand F. The evaluation of renal function and disease in patients with cirrhosis. J Hepatol 2010; 52: 605-13.

6. Gerbes AL, Gülberg V, Bilzer M, Vogeser M. Evaluation of serum cystatin C concentration as a marker of renal function in patients with cirrhosis of the liver. Gut 2002; 50: 106-10.

7. Cholongitas E, Shusang V, Marelli L, Nair D, Thomas M, Patch D, Burns A, et al. Review article: renal function assessment in cirrhosis-difficulties and alternative measurements. Aliment Pharmacol Ther 2007; 26: 969-78.

8. Takeuchi M, Fukuda Y, Nakano I, Katano Y, Hayakawa T. Elevation of serum cystatin C concentrations in patients with chronic liver disease. Eur J Gastroenterol Hepatol 2001; 13: 951-5.

9. Chu S-C, Wang C-P, Chang Y-H, Hsieh YS, Yang SF, Su JM, Yang CC, et al. Increased cystatin C serum concentrations in patients with hepatic deisease of various severities. Clin Chim Acta 2004; 341: 133-8.

10. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group. Hepatology 1994; 20: 15-20.

11. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, Lok AS. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38: 518-26.

12. Friedman SL. Mechanisms of hepatic fibrogenesis. Gastroenterology 2008; 134: 1655-69.

13. Shi GP, Sukhova GK, Grubb A, Ducharme A, Rhode LH, Lee RT, Ridker PM, et al. Cystatin C deficiency in human atherosclerosis and aortic aneurisms. J Clin Invest 1999; 104:1191-7.

14. Gressner AM, Lahme B, Meurer SK, Gressner O, Weiskirchen R. Variable expression of cystatin C in cultured trans-differentiating rat hepatic stellate cells. World J Gastroenterol 2006; 12: 731-8.

15. Neuman MG, Benhamou JP, Marcellin P, Valla D, Malkiewicz IM, Katz GG, Trepo C, et al. Cytokine-chemokine and apoptotic signatures in patients with hepatitis C. Transl Res 2007; 149: 126-36.

16. Seo YS, Jung ES, An H, Kim JH, Jung YK, Kim JH, Yim HJ, et al. Serum cystatin C level is a good prognostic marker in patients with cirrhotic ascites and normal serum creatinine levels. Liver Int 2009; 29: 1521-7.