Recurrence of hepatitis C after liver transplantation is associated with increased systemic IL‐10 levels

Patricia A Sheiner,Thomas Fishbein,Myron E Schwartz,Sukru Emre,Sander S Florman,Charles M Miller,Peter Boros

doi:10.1080/09629350124104

Patricia A Sheiner, Thomas Fishbein + Show 5 more

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https://doi.org/10.1080/09629350124104

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Abstract

Recurrence of hepatitis C after liver transplantation is an almost universal occurrence. T-cell derived cytokines have an important role in the development of liver damage associated with chronic hepatitis C, their post-transplant levels, however, have not been correlated with histologic recurrence of the disease. We sought to analyze levels of TNF-alpha, soluble IL-2 receptor, IL-4 and IL-10 at 1 month, 6 months and 1 year after transplantation in 27 patients undergoing transplantation for hepatitis C related end-stage liver disease. HCV RNA levels were monitored by a branched-chain DNA signal amplification assay. Diagnosis of recurrent hepatitis was based on 1-year protocol biopsies and on biopsies performed for liver enzyme elevations. Recurrent hepatitis C was detected in 52% (n=14) of the 27 patients. HCV RNA levels rose over time in all patients regardless of histologic recurrence. TNF-alpha, and IL-4 levels, although elevated, did not show specific patterns over time or in correlation with recurrence. Similarly, the early elevation followed by a gradual decrease over the first year in the amount of soluble IL-2 receptor was not related to histologic recurrence. We observed a significant increase in circulating IL-10 levels over the first year in patients with biopsy-proven recurrence, while patients with no signs of histologic recurrence displayed increased, but steady levels. These results suggest that while these cytokines are associated with post-transplant recurrence of hepatitis C, their production may be altered by additional factors.

Highlights

Hepatitis C is a progressive disease that leads to cirrhosis in approximately 20% of affected individuals[1,2,3] and has emerged as the most common indication for liver transplantation in both Europe and the USA.[4]
The immunologic mechanisms involved in chronic hepatitis C-related liver injury are not fully understood, and these events may be even more complex in recurrent hepatitis C following transplantation
We observed that in patients who undergo liver transplantation for hepatitis C infection, viral levels rise over the first year regardless of histologic recurrence

Summary

Introduction

Hepatitis C is a progressive disease that leads to cirrhosis in approximately 20% of affected individuals[1,2,3] and has emerged as the most common indication for liver transplantation in both Europe and the USA.[4]. T-cell derived cytokines have an important role in the development of liver damage associated with chronic hepatitis C, their post-transplant levels, have not been correlated with histologic recurrence of the disease. Aims: We sought to analyze levels of TNF-a , soluble IL2 receptor, IL-4 and IL-10 at 1 month, 6 months and 1 year after transplantation in 27 patients undergoing transplantation for hepatitis C related end-stage liver disease. HCV RNA levels rose over time in all patients regardless of histologic recurrence. TNF-a , and IL-4 levels, elevated, did not show specific patterns over time or in correlation with recurrence. The early elevation followed by a gradual decrease over the first year in the amount of soluble IL-2 receptor was not related to histologic recurrence. Conclusions: These results suggest that while these cytokines are associated with post-transplant recurrence of hepatitis C, their production may be altered by additional factors

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