Email this article 
Post a Comment Role of inflammation and iron exchange disorders in progression of liver cirrosis
- Authors: Bulatova I.A.1, Shchekotova A.P.1, Paducheva S.V.2
-
Affiliations:
- E.A. Vagner Perm State Medical University
- City Clinical Hospital № 2 named after F. Kh. Gral
- Issue: Vol 38, No 1 (2021)
- Pages: 38-45
- Section: Original studies
- URL: https://ogarev-online.ru/PMJ/article/view/65047
- DOI: https://doi.org/10.17816/pmj38138-45
- ID: 65047
Cite item
Full Text
Abstract
Objective. To assess the role of the main pathogenetically significant molecules, including tumor necrosis factor alpha (TNF-α) and transferrin, as an inflammatory protein, in the progression of chronic diffuse liver diseases (CDLD).
Material and methods. The study involved 86 patients with cirrhosis of the liver (LC) of viral, alcoholic and mixed etiology. Inflammatory parameters were studied, including tumor necrosis factor alpha (TNF-α), indicators of iron metabolism, α-fetoprotein (AFP), vasculoendothelial growth factor (VEGF), and functional liver biochemical tests. The control group consisted of 70 persons.
Results. It was revealed that the LC severity class is interrelated with the clinical manifestations of the disease, the severity of biochemical syndromes as well as a significant increase in the concentration of γ-globulins, CRP, the amount of TNF-α up to 3.5 (2.6–4.7) pg/ ml (p < 0.001) and ferritin up to 325.8 (209; 401) ng / ml (p < 0.001) compared to the control group. An increase in TNF-α and ferritin as inflammatory protein in LC confirms the growth of the activity of inflammation in the liver and correlates with other parameters involved in the pathogenesis of LC: with VEGF, as a marker of endothelial dysfunction, which is involved in the activation of fibrosis and neoangiogenesis, and AFP, reflecting regeneration processes in the liver.
Conclusions. The progression of liver damage in cirrhosis is based primarily on the secondary inflammation caused by portal hypertension with the entry of intestinal antigens and toxins into the central bloodstream. At the same time, the perverse circle of the development of the disease is closed.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
I. A. Bulatova
E.A. Vagner Perm State Medical University
Author for correspondence.
Email: bula.1977@mail.ru
MD, PhD, Professor, Head of Department of Normal Physiology, Professor of Department of Faculty Therapy № 2, Professional Pathology and Clinical Laboratory Diagnostics
Russian Federation, PermA. P. Shchekotova
E.A. Vagner Perm State Medical University
Email: bula.1977@mail.ru
MD, PhD, Professor, Department of Faculty Therapy № 2, Professional Pathology and Clinical Laboratory Diagnostics
Russian Federation, PermS. V. Paducheva
City Clinical Hospital № 2 named after F. Kh. Gral
Email: bula.1977@mail.ru
Candidate of Medical Sciences, Head of Clinical Diagnostic Laboratory
Russian Federation, PermReferences
- Ellis E.L, Mann D.A. Clinical evidence for the regression of liver fibrosis. Journal of Hepatology 2012; 56: 1171–1180.
- Mekhtiev S.N., Stepanenko V.V., Zinov'eva E.N., Mekhtieva O.A. Modern ideas about liver fibrosis and methods of its correction. Farmateka 2014; 6: 80–87 (in Russian).
- Zhdanov K.V., Gusev D.A., Chirskiy V.A., Kozlov K.V., Shkuro A.V, Lavrov, A.V. Iron and the pathogenesis of chronic hepatitis C. Medicinskij vestnik severnogo Kavkaza 2009; 2: 11–18 (in Russian).
- Sherlok Sh., Duli Dzh. Diseases of the liver and biliary tract: a practical guide: translation from English. ed. Z.G. Aprosina, N.A. Mukhina. Moscow: GEOTAR-MED. 2002; 864 (in Rus-sian).
- Gusev E.Yu., Chereshnev V.A., Zhuravleva Yu.A., Solomatina L.V., Zubova T.E. Variants of the development of chronic systemic inflammation. Medicinskaja immunologija 2009; 2‒3 (11): 131–140 (in Russian).
- Albillos A., Lario М., Álvarez-Mon М. Cirrosis-associated immune distinctive features and clinical relevance. Journal of Hepatology 2014; 61 (6): 1385.96.77.
- Bulatova I.A., Shchekotova A.P., Dolgikh O.V., Paducheva S.V. Cytokine status in patients with liver cirrhosis of various etiology. Sovremennye problemy nauki i obrazovanija 2016, available at: http://www.Scienceeducation.ru/articale/view?id = 24755 (in Russian).
- EASL-ALEN Clinical Practice Guidelines: Management of alcohol-related liver disease. Journal of Hepatology 2018; 69: 154–181.
- Levitan B.N., Astakhin A.V., Levitan G.B. Tumor necrosis factor and its soluble receptors in chronic hepatitis and liver cirrhosis. Jeksperimental'naja i klinicheskaja gastrojenterologija 2017; 2 (138): 62–66 (in Russian).
- Chen C.H., Lin S.T., Kuo C.L., Nien C.K. Clinical significance of elevated alpha-fetoprotein (AFP) in chronic hepatitis C without hepatocellular carcinoma. Journal of Hepatogastroenterology 2008; 55 (85): 1423–1427.
- Shapiro I.Ya., Sek O.O., Knoring B.E. Features of the immune response and cytokine status in different variants of the course of liver cirrhosis. Medicinskaja immunologija 2002; 4‒5: 545–552 (in Russian).
- Bulatova I.A. Fibrosis in chronic liver diseases: mechanisms of development, clinical and laboratory assessment of progression and monitoring of therapy: author. dis. doct. honey. sciences. Perm 2016 (in Russian).
Supplementary files
