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Role of hepatocyte growth factor in hepatitis c patients on dialysis

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Internal Medicine

Advisors

El-Feqi, Abdel-Fattah , Qenawi, Aly M. , Abou-El-Enain, Azza

Authors

Rihan, Muhammad Kamal

Accessioned

2017-03-30 06:21:28

Available

2017-03-30 06:21:28

type

M.D. Thesis

Abstract

HGF plays an essential part in the development and regeneration of the liver; it shows anti-apoptotic activity in hepatocytes (Ueki et al., 1999). It up-regulates Bcl-xL, a protein that regulates apoptosis (Fornoni et al., 2001). HGF is a potent mitogen for hepatocytes in vivo as well as in vitro (Spijkers et al., 2001). It is the most potent hepatocyte proliferation stimulator (Rubin et al., 2001). HGF appears to act in a renotropic and nephroprotective manner during acute renal damage. Recent studies suggest that HGF is also of importance in chronic renal diseases (Randers et al., 2001). HGF is known to promote regeneration of damaged renal epithelial cells (Nagano et al., 2002). Rampino et al., 1999 stated that hemodialysis increases markedly the serum levels of Hepatocyte growth factor, so the regular dialysis treatment mimics the regular administration of HGF as a drug. The aim of this work is to study the levels and effects of HGF in HCV positive chronic renal failure patients, on conservative and regular hemodialysis treatment. In this study, we test the hypothesis that liver damage caused by HCV infection is less severe in patients on regular dialysis treatment, that is, in patients in whom "pharmacological" HGF serum levels challenge the viral action. The study included three groups of hepatitis C virus (HCV) positive patients; group one with chronic renal failure on regular hemodialysis (30 patients), group two of uraemic patients on conservative treatment (10 patients), and group three without renal disease (10 patients). The patients were of both sexes and of different age groups. All groups have anti-HCV serum positive tests and positive qualitative polymerase chain reaction (PCR) for HCV. Patients received treatment for hepatitis, hepatitis B virus (HBV) positive patients and alcohol abusers were excluded. All patients were subjected for: Liver enzymes (alanine trasferase “ALT”, aspartate transferase “AST” and alkaline phosphatase), Liver function biochemical tests (total bilirubin, serum albumin, prothrombin time “PT”, concentration “PC” and International Normalized Ratio “INR”), serum urea and creatinine, Hepatocyte growth factor (HGF), and real time abdominal ultrasonography using (Hitachi EUB-315: 3.5 MHz, or Toshiba ECC-CEE: 3.75 MHz ultrasonography scanners), some sonar-guided liver biopsies were done for some randomly selected cases. It is noticed that group 1 patients (HCV positive on RDT) show significnt least mean values of ALT, AST and bilirubin. They also show significant best mean values of serum albumin and INR. No significant difference between groups 2 and 3. The histological grading and staging scores in groups 2 and 3 are similar but they are worse than those in group 1. This study gives evidence that hemodialysis modifies the course of HCV-related liver disease. Hemodialysis is a potent stimulus to HGF production, it increases strikingly during dialysis. This may provide a basis for the possible future theraputic use of HGF in chronic hepatitis C.

Issued

1 Jan 2003

Details

Type

Thesis

Created At

31 Jan 2023