Serum levels of hepatocyte growth factor (HGF)‎, tumour necrosis factor alpha (TNF-a)‎ and soluble fas (sFas)‎ in patients with schistosomiasis and patients with hepatic cirrhosis

الملخص EN

Background Periportal fibrosis of the liver in Schistosoma mansoni infection is a consequence of excessive deposition of collagen by hepatic stellate cells (HSC). The classic pipestem fibrosis is due to fibrotic bands originating from granulomas and the hepatic architecture is still intact.

Cirrhosis is a diffuse process of fibrosis following hepatocellular necrosis with nodule formation Aim: this study aimed to assess serum levels of HGF, TNF -α and sFas in patients with schistosomiasis and patients with hepatic cirrhosis due to virus C infection and their role in the process of liver fibrosis and cirrhosis Subjects : this study was performed on 36 subjects : 12 schistosomal and 12 cirrhotic, compared to 12 control subjects.

To all patients, thorough clinical examination and abdominal sonography were performed. Methods : the following laboratory investigations were done; routine biochemical parameters, serum, HGF, TNF -α and sFas. Results : in the schistosomal group serum levels of HGF, TNF -α and sFas were significantly higher than those of the control subjects.

Also in the cirrhotic group the values were significantly higher when compared to those of the control group.

When comparing the two groups of patients, serum levels of HGF and sFas were significantly lower while TNF -α level was significantly higher in the cirrhotic group than the schistosomal one. HGF correlated negatively with TNF -α in the cirrhotic group Conclusion: In the schistosomal patients, two opposite mechanisms are most probably occurring at the same time one antifibrotic, demonstrated by the significantly high levels of HGF that inhibits stellate cell and TNF -α and the other is in favour of fibrogenesis and is showed by the marked increased levels of sFas in order to protect the liver from miracidial antigens by inhibiting stellate cell apoptosis. Balance between these two mechanisms is important for beneficial effect to be attained.

Cirrhotic patients have elevated serum levels of HGF and TNF -α both cause stimulation of regeneration and inhibition of fibrosis, while the increased level of sFas which is antiapoptotic is a very important compensatory mechanism in a trial to protect the hepatocytes from undergoing apoptosis that causes liver injury.