Original Article
Copyright ©2012 Baishideng. All rights reserved.
World J Hepatol. Aug 27, 2012; 4(8): 242-247
Published online Aug 27, 2012. doi: 10.4254/wjh.v4.i8.242
Relationship between vitamin D and IL-23, IL-17 and macrophage chemoattractant protein-1 as markers of fibrosis in hepatitis C virus Egyptians
Noha M El Husseiny, Hala M Fahmy, Waleed A Mohamed, Hisham H Amin
Noha M El Husseiny, Hala M Fahmy, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo 11111, Egypt
Waleed A Mohamed, Department of Chemistry, Cairo University, Cairo 12534, Egypt
Hisham H Amin, Clinical Pathology Department, Faculty of Medicine AL Azhar University, Cairo 15533, Egypt
Author contributions: El Husseiny NM did the statistics and wrote the manuscript; Mohamed WA put the idea of the research, collected the data and did the laboratory work; Fahmy HM participated in the idea of the research and participated in writing the manuscript; Amin HH participated in the laboratory work and data collection.
Correspondence to: Noha M El Husseiny, MD, Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo 11111, Egypt. dr_noha2002@yahoo.com
Telephone: +20-100-6803571 Fax: +20-223-667260
Received: January 1, 2012
Revised: August 6, 2012
Accepted: August 23, 2012
Published online: August 27, 2012
Abstract

AIM: To assess vitamin D in hepatitis C patients and its relationship to interleukin (IL)-23, IL-17, and macrophage chemoattractant protein-1 (MCP-1).

METHODS: The study was conducted on 50 Egyptian hepatitis C virus (HCV) genotype number IV-infected patients and 25 age- and gender-matched healthy subjects. Venous blood samples were obtained. Samples were allowed to clot and sera were separated by centrifugation and stored at -20 °C. A 25 hydroxy vitamin D assay was carried out using solid phase RIA. A 1,25 dihydroxy vitamin D assay was carried out using a commercial kit purchased from Incstar Corporation. IL-17 and -23 and MCP-1 were assayed by an enzyme immunoassay. Quantitative and qualitative polymerase chain reaction for HCV virus were done by TaqMan technology. Only HCV genotype IV-infected subjects were included in the study. The mean ± SD were determined, a t-test for comparison of means of different parameters was used. Correlation analysis was done using Pearson’s correlation. Differences among different groups were determined using the Kruskal-Wallis test.

RESULTS: The mean vitamin D level in HCV patients (group I) was 15 ± 5.2 ng/mL while in control (group II) was 39.7 ± 10.8. For active vitamin D in group I as 16.6 ± 4.8 ng/mL while in group II was 41.9 ± 7.9. IL-23 was 154 ± 97.8 in group I and 6.7 ± 2.17 in group II. IL-17 was 70.7 ± 72.5 in cases and 1.2 ± 0.4 in control. MCP-1 was 1582 ± 794.4 in group I and 216.1 ± 5.38 in group II. Vitamin D deficiency affected 72% of HCV-infected patients and 0% of the control group. Vitamin D insufficiency existed in 28% of HCV-infected patients and 12% of the control group. One hundred percent of the cirrhotic patients and 40% of non cirrhotic HCV-infected patients had vitamin D deficiency. IL-23, IL-17, and MCP-1 were markedly increased in HCV-infected patients in comparison to controls.A significant negative correlation between vitamin D and IL-17 and -23 and MCP-1 was detected. HCV-infected males and females showed no differences with respect to viral load, vitamin D levels, IL-17, IL-23 and MCP-1. The viral load was negatively correlated with vitamin D and active vitamin D (P = 0.0001 and P = 0.001, respectively), while positively correlated with IL-23, IL-17, and MCP-1. We classified the patients according to sonar findings into four groups. Group Ia with bright hepatomegaly and included 14 patients. Group Ib with perihepatic fibrosis and included 11 patients. Group Ic with liver cirrhosis and included 11 patients. Group Id with hepatocellular carcinoma (HCC) and included 14 patients. Vitamin D and active vitamin D were shown to be lower in cirrhotic patients and much lower in patients with HCC, and this difference was highly significant (P = 0.0001). IL-17 and -23 and MCP-1 were higher in advanced liver disease) and the differences were highly significant (P = 0.0001).

CONCLUSION: Whether the deficiency of vitamin D is related to HCV-induced chronic liver disease or predisposing factor for higher viral load is a matter of debate.

Keywords: Vitamin D; Macrophage chemoattractant protin-1; Liver cirrhosis; Interleukin-23; Interleukin-17; Liver cirrhosis