Monika Gudowska

Hyaluronic acid concentration in liver diseases

The aim of this study was to evaluate the effect of liver diseases of different etiologies and clinical severity of liver cirrhosis on the serum level of hyaluronic acid. The results were compared with noninvasive markers of liver fibrosis: APRI, GAPRI, HAPRI, FIB-4 and Forn’s index. Serum samples were obtained from 20 healthy volunteers and patients suffering from alcoholic cirrhosis (AC)—57 patients, non-alcoholic cirrhosis (NAC)—30 and toxic hepatitis (HT)—22. Cirrhotic patients were classified according to Child–Pugh score. Hyaluronic acid concentration was measured by the immunochemical method. Non-patented indicators were calculated using special formulas. The mean serum hyaluronic acid concentration was significantly higher in AC, NAC and HT group in comparison with the control group. There were significant differences in the serum hyaluronic acid levels between liver diseases, and in AC they were significantly higher than those in NAC and HT group. The serum hyaluronic acid level differs significantly due to the severity of cirrhosis and was the highest in Child–Pugh class C. The sensitivity, specificity, accuracy, positive and negative predictive values and the area under the ROC curve for hyaluronic acid and all non-patented algorithms were high and similar to each other. We conclude that the concentration of hyaluronic acid changes in liver diseases and is affected by the severity of liver cirrhosis. Serum hyaluronic acid should be considered as a good marker for noninvasive diagnosis of liver damage, but the combination of markers is more useful.

Serum Carbohydrate-Deficient Transferrin in Pancreatic Diseases of Different Etiologies

BACKGROUND The aim of this study was to find out whether pancreatic diseases invalidate the use of CDT for the detection of high alcohol intake and if CDT can distinguish between alcoholic and non-alcoholic pancreatitis. METHODS The study was carried out on 110 patients with pancreatic diseases. Serum CDT was determined using the N Latex CDT test. RESULTS The mean relative (%) and absolute (mg/L) CDT levels in acute and chronic pancreatitis were significantly higher than in controls and patients with primary pancreatic cancer. No significant difference was found in CDT concentrations between acute and chronic pancreatitis. The relative and absolute CDT concentrations in alcohol-induced pancreatitis were significantly higher compared to the controls and biliary-induced pancreatitis. CONCLUSIONS Acute and chronic alcoholic pancreatitis, but not biliary pancreatitis, may affect CDT levels. Pancreatitis does not invalidate the use of CDT as a marker of alcohol abuse. CDT can be a useful test for distinguishing alcoholic from non-alcoholic pancreatitis. Changes in CDT level indicate disturbances in transferrin glycosylation in the course of alcoholic pancreatic diseases.

The concentration of total sialic acid in chronic hepatitis B and C

Background The synthesis and glycosylation of glycoproteins and glycolipids take place in the liver. Thus, liver diseases may affect serum concentrations of some carbohydrate derivatives, especially the concentration of sialic acid which is attached to the end of oligosaccharide chains. The aim of this study was to measure and compare the serum concentration of total sialic acid in chronic hepatitis B and C. The hypothesis is that both viruses responsible for the development of inflammation work differently at the cellular level. Methods Serum samples were obtained from 90 patients suffering from liver diseases: 50 from chronic hepatitis B and 40 from chronic hepatitis C at the time of diagnosis. The total sialic acid concentration in the serum was measured according to the enzymatic method using a colorimetric procedure. Results The mean total sialic acid concentration in patients with chronic hepatitis B was significantly lower than the mean concentration in the healthy group, while in patients with chronic hepatitis C, it was significantly higher than that in healthy people and in patients suffering from chronic hepatitis B. There were no significant differences in total sialic acid concentrations in patients with chronic hepatitis B and C according to the grade of portal/periportal activity, the grade of lobular activity and the stage of fibrosis. Conclusions We conclude that chronic viral hepatitis affects the total serum concentration of sialic acid. Moreover, the concentration of total sialic acid may be a useful marker to differentiate between chronic hepatitis B and C but is not useful for evaluation of the progression of these diseases.

Independence of carbohydrate-deficient isoforms of transferrin and cyclic citrullinated peptides in rheumatoid arthritis.

OBJECTIVE The aim of this study was to assess the relationship between the two types of posttranslational modifications of proteins in RA: glycosylation on the example of carbohydrate-deficient transferrin and citrullination by means of autoantibodies to cyclic citrullinated peptides. METHODS The study was carried out in 50 RA patients. CDT was measured using N Latex CDT immunonephelometric test, the results were presented in absolute and relative units. Anti-CCP were measured using the chemiluminescent method and rheumatoid factor by immunoturbidimetric method. RESULTS 80% of RA patients were positive for anti-CCP, 70% for RF and 62% for both, anti-CCP and RF. The level of %CDT was significantly elevated, but absolute CDT level was not changed. The mean absolute CDT concentration was higher in anti-CCP positive patients than that in anti-CCP negative. CDT (absolute and relative concentration) did not correlate with anti-CCP and RF. However, serum RF significantly correlated with anti-CCP. %CDT did not correlate with anti-CCP, but absolute level correlated with anti-CCP only in anti-CCP negative and RF negative patients. CDT did not correlate with RF, but solely with anti-CCP in anti-CCP negative patients. Anti-CCP correlated with DAS 28 only in anti-CCP negative RA, but CDT (absolute and relative units) correlated with DAS 28 in all patients and in anti-CCP positive RA. CONCLUSIONS These results suggest that the changes in CDT and anti-CCP concentrations are not associated with oneself and indicate on the independence of these posttranslational modifications in rheumatoid arthritis. Only the alterations in transferrin glycosylation reflected the activity of RA.

Independência de isoformas de transferrina deficiente em carboidrato e peptídeos citrulinados cíclicos na artrite reumatoide

OBJECTIVE The aim of this study was to assess the relationship between the two types of posttranslational modifications of proteins in RA: glycosylation on the example of carbohydrate-deficient transferrin (CDT) and citrullination by means of autoantibodies to cyclic citrullinated peptides (anti-CCP). METHODS The study was carried out in 50 RA patients. CDT was measured using N Latex CDT immunonephelometric test, the results were presented in absolute and relative units. Anti-CCP were measured using the chemiluminescent method and rheumatoid factor (RF) by immunoturbidimetric method. RESULTS 80% of RA patients were positive for anti-CCP, 70% for RF and 62% for both, anti-CCP and RF. The level of %CDT was significantly elevated, but absolute CDT level was not changed. The mean absolute CDT concentration was higher in anti-CCP positive patients than that in anti-CCP negative. CDT (absolute and relative concentration) did not correlate with anti-CCP and RF. However, serum RF significantly correlated with anti-CCP. %CDT did not correlate with anti-CCP, but absolute level correlated with anti-CCP only in anti-CCP negative and RF negative patients. CDT did not correlate with RF, but solely with anti-CCP in anti-CCP negative patients. Anti-CCP correlated with DAS 28 only in anti-CCP negative RA, but CDT (absolute and relative units) correlated with DAS 28 in all patients and in anti-CCP positive RA. CONCLUSIONS These results suggest that the changes in CDT and anti-CCP concentrations are not associated with oneself and indicate on the independence of these posttranslational modifications in rheumatoid arthritis. Only the alterations in transferrin glycosylation reflected the activity of RA.

High serum N-terminal propeptide of procollagen type III concentration is associated with liver diseases

Introduction N-terminal propeptide of procollagen type III (PIIINP) is generated during the synthesis of type III collagen. PIIINP can be measured in the serum as an indicator of liver fibrosis and cirrhosis. Aim To evaluate the effect of liver diseases of different aetiologies and clinical severity of liver cirrhosis on the serum level of PIIINP. Material and methods Patients with alcoholic cirrhosis (AC) – 63 subjects, non-alcoholic cirrhosis (NAC) – 31 and toxic hepatitis (HT) – 33 were studied. Cirrhotic patients were classified according to the Child-Pugh scale. The samples were analysed using the ELISA method. Results The level of PIIINP was significantly higher in patients with alcoholic cirrhosis, non-alcoholic cirrhosis, and toxic hepatitis in comparison to the control group. There were no significant differences in the serum PIIINP levels between liver diseases and according to the severity of liver cirrhosis. PIIINP has the highest diagnostic power for the diagnosis of toxic hepatitis. The highest sensitivity was reached in alcoholic cirrhosis, but other diagnostic values (specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy (ACC)) in alcoholic cirrhosis were lower than that in toxic hepatitis. In the diagnosis of non-alcoholic cirrhosis PIIINP has low sensitivity, specificity, PPV, NPV, and ACC. Conclusions The serum PIIINP shows the alterations in liver diseases in comparison to healthy controls, but not between diseases. Taking the above into account we can suggest that PIIINP may be a useful test for the detection of liver diseases.

Changed Profile of Serum Transferrin Isoforms in Liver Diseases

BACKGROUND The aim of the study was to assess the effect of liver diseases on the serum profile of transferrin isoforms. METHODS Patients with alcoholic cirrhosis (AC) - 63 subjects, non-alcoholic cirrhosis (NAC) - 28, and toxic hepatitis (HT) - 32 were studied. The cirrhotic patients were classified according to the Child-Pugh scale. Samples were analyzed by capillary electrophoresis with the MINICAP system. RESULTS Significant differences were noted in the relative concentrations of disialotransferrin in HT patients (mean ± SD; 1.216 ± 0.900%) and in the levels of trisialotransferrin in AC (6.433 ± 3.131%) and NAC patients (5.311 ± 2.401%), as compared to the control group (0.984 ± 1.161%; 3.615 ± 1.156%, respectively). The levels of di-, tri- and tetrasialotransferrin appeared to differ between liver diseases. The mean relative concentration of disialotransferrin was significantly higher in patients with HT than in the NAC group, whereas trisialotransferrin level was lower in HT (4.074 ± 1.597%) than in AC and NAC. Tetrasialotransferrin was higher in HT (78.474 ± 4.393%) and NAC (77.932 ± 4.161%) in comparison with AC (75.290 ± 4.720%). Eleven percent of cirrhotic samples showed di-tri bridging and two samples displayed genetic variants of transferrin isoforms. There were significant differences in tri-, tetra-, and pentasialotransferrin according to the Child-Pugh score. The level of trisialotransferrin was significantly higher in class C of liver cirrhosis (7.219 ± 3.107%) than in class A (4.590 ± 1.851%), and tetrasialotransferrin relative concentration was lower in class C (69.048 ± 14.251%) as compared to class B (76.929 ± 3.931%) and A (78.990 ± 2.995%). The level of pentasialotransferrin was higher in class C (23.078 ± 15.898%) than in B (16.455 ± 4.491%) and A (15.680 ± 2.333%). CONCLUSIONS In conclusion, the serum profile of transferrin isoforms shows alterations in liver diseases, varies according to the disease, and changes depending on the cirrhosis stage.

The transferrin isoforms in chronic hepatitis

BACKGROUND The aim of this study was to evaluate the effect of chronic hepatitis on the serum profile of transferrin isoforms. METHODS Tested group consist of 160 patients with chronic hepatitis. The samples were analyzed by capillary electrophoresis on MINICAP electrophoretic system (Sebia, France). RESULTS In patients with chronic hepatitis tetrasialotransferrin level was increased (P=0.002) and pentasialotransferrin decreased (P=0.009). Moreover, statistical analysis revealed that trisialotransferrin level was different according to the grade of portal/periportal activity (P=0.009), the grade of lobular activity (P=0.004) and the stage of fibrosis (P=0.022). There were no differences in tetrasialotransferrin and pentasialotransferrin according to the advancement of hepatitis activity and the stage of fibrosis (P>0.05 for all comparisons). CONCLUSIONS We conclude that chronic hepatitis affect the serum profile of transferrin isoforms, but only trisialotransferrin level could be useful in determining progression of chronic hepatitis and the stage of fibrosis.

The role of serum hyaluronic acid determination in the diagnosis of liver diseases

The common pathway leading to liver fibrosis and cirrhosis is growing deposition of extracellular matrix (ECM). It results from molecular and histological rearrangement of collagens, glycoproteins and hyaluronans. Hyaluronic acid is a chief component of the extracellular matrix of connective tissues and plays the main structural role in the formation of ECM. The most important organ involved in the synthesis of hyaluronic acid is the liver. In this paper the meaning of hyaluronic acid in the diagnostics of liver diseases is discussed. Here, we focus on the described changes of hyaluronic acid concentration in the pathological processes of the liver, including alcoholic and non-alcoholic liver diseases. The results of published clinical studies have shown its high diagnostic sensitivity, which probably enables its application in laboratory diagnosis.

Selected Noninvasive Markers in Diagnosing Liver Diseases

OBJECTIVE To evaluate the effectiveness of certain noninvasive liver-damage markers in predicting liver diseases and the clinical severity of liver cirrhosis. METHODS We tested serum specimens from 57 patients with alcoholic cirrhosis, 30 with nonalcoholic cirrhosis, and 22 with toxic hepatitis (TH). The Bonacini, King, and Göteborg University Cirrhosis Index (GUCI) scores were calculated using specific formulas. RESULTS The values of the Bonacini and King scores significantly differ between liver diseases. The Bonacini score was higher in alcoholic and nonalcoholic cirrhosis than in TH, and the King score was higher in alcoholic cirrhosis than in TH. All of the tested scores appeared to vary according to the severity of liver damage and were higher in Child-Pugh class C than that in classes A and B. CONCLUSIONS We conclude that the Bonacini and King scores differ between liver diseases and that all the tested scores reflect the severity of liver cirrhosis.