title: Apoptotic cytokeratin 18 neoepitopes in serum of patients with chronic hepatitis C.
abstract: In patients with chronic hepatitis C, alanine aminotransferase (ALT) levels do not accurately reflect the extent of liver inflammation. The discrepancy between ALT level and liver damage could be related to the mode of cell death. In the present study, we quantified serum levels of apoptotic cytokeratin 18 (CK-18) neoepitopes that are generated by activated caspases during apoptosis. Apoptotic CK-18 neoepitopes were quantified by enzyme linked immunosorbent assay in sera from patients with chronic hepatitis C and elevated ALT levels (n = 72), patients with chronic hepatitis C and persistently normal ALT levels (n = 27) and healthy controls (n = 19). Serum CK-18 neoepitope levels were strongly correlated with ALT (r = 0.659, P < 0.0001) and the histology activity index (r = 0.374, P < 0.001). Patients with chronic hepatitis C and persistently normal ALT levels had higher apoptotic CK-18 neoepitope levels than healthy controls (P = 0.03) but lower levels than patients with chronic hepatitis C and elevated ALT levels (P < 0.001). Highest serum CK-18 neoepitope levels were observed in patients with cirrhosis (P = 0.002). Hence apoptotic CK-18 neoepitopes in serum of patients with chronic hepatitis C are associated with ALT level and histological liver damage. Serum apoptotic CK-18 neoepitope levels are elevated both in patients with chronic hepatitis C and elevated ALT levels as well as in patients with normal ALT levels indicating that also patients with chronic hepatitis C and normal ALT have an increased hepatocyte loss by apoptosis.
authors.affiliation: Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kronenberger
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: E
authors.initials: E
authors.lastname: Herrmann
authors.forename: U
authors.initials: U
authors.lastname: Mihm
authors.forename: A
authors.initials: A
authors.lastname: Piiper
authors.forename: C
authors.initials: C
authors.lastname: Sarrazin
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood / Q000378:metabolism; D017209:Apoptosis / Q000502:physiology*; D015415:Biomarkers / Q000097:blood; D001707:Biopsy, Needle; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000097:blood*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D007633:Keratins; D000410:Alanine Transaminase