Abstract
Background: This study aimed to correlate serum Hyaluronic Acid (HA) and soluble intercellular adhesion molecule-1 (sICAM-1), with severity of liver fibrosis as clinically and histologically assessed in viral hepatitis, schistosomiasis mansoni and co-infected patients. Methods: The study was performed on 4 groups: Group 1 (G1) 15 chronic hepatitis patients; Group 2 (G2) 15 chronic schistosomiasis mansoni co-infected with chronic hepatitis patients; Group 3 (G3) 15 chronic schistosomiasis mansoni without hepatitis patients; Group 4 (G4) 15 active schistosomiasis mansoni without hepatitis patients. Results:The results showed a significant high level of HA and sICAM-1 in all groups compared to G4, while a significantly high level of HA in G2 compared to G3. There was a highly significant positive correlation between the level of HA and sICAM-1 and between both of them, and Child-Pugh clinical classification of patients with higher levels in Child-Pugh C. Also, serum level of both HA and sICAM-1 was positively correlated to the severity of liver fibrosis assessed by biopsy, with a highly significant higher level in advanced stages 4 and 5. Conclusions: HA and sICAM-1 showed good diagnostic performance and could discriminate severe from mild liver fibrosis, enabling them to be used as valuable non-invasive markers to identify and follow up patients with liver fibrosis.
Highlights
Schistosomiasis mansoni is a chronic liver disease that is endemic in rural areas of Egypt
Analysis of the results showed that the percent of Child-Pugh classification B was higher (40%) in the hepatitis group (G1), while that of classification C was higher (20%) in chronic schistosomiasis coinfected with hepatitis group (G2), as compared to the other groups
Analysis of liver biopsy stages showed that the percent of advanced stages 2, 3, 4 and 5 were increased in the chronic schistosomiasis co-infected with hepatitis group, as compared to the hepatitis group (Table 1)
Summary
Schistosomiasis mansoni is a chronic liver disease that is endemic in rural areas of Egypt. Some portion of tissue HA enters into the general circulation via lymphatics, and is mainly taken up by sinusoidal endothelial cells in the liver through hyaluronate receptors and degraded in lysosomes. Decreased function of sinusoidal endothelial cells in advanced liver diseases may raise serum levels of HA, through decreased number of hyaluronate receptors and reduced degradation of HA in the endothelial cells [9]. This marker is of interest in chronic liver diseases to avoid liver biopsy. This study aimed to correlate serum Hyaluronic Acid (HA) and soluble intercellular adhesion molecule-1 (sICAM-1), with severity of liver fibrosis as clinically and histologically assessed in viral hepatitis, schistosomiasis mansoni and co-infected patients
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