Matrix-derived serum markers in monitoring liver fibrosis in children with chronic hepatitis B treated with interferon alpha.
OBJECTIVE
To evaluate prospectively 4 selected serum fibrosis markers (tenascin, hyaluronan, collagen VI, TIMP-1) before, during and 12 mo after IFN treatment of children with chronic hepatitis B.


METHODS
Forty-seven consecutive patients with chronic hepatitis B (range 4-16 years, mean 8 years) underwent IFN treatment (3 MU tiw for 20 wk). Fibrosis stage and inflammation grade were assessed in a blinded fashion before and 12 mo after end of treatment. Serum fibrosis markers were determined using automated assays.


RESULTS
IFN treatment improved histological inflammation but did not change fibrosis in the whole group or in subgroups. Only hyaluronan correlated significantly with histological fibrosis(r = 0.3383, P = 0.021). Basal fibrosis markers did not differ between responders (42.5%) and nonresponders(57.5%). During IFN treatment only serum tenascin decreased significantly in the whole group and in nonresponders. When pretreatment values were compared to values 12 mo after therapy, TIMP-1 increased in all patients and in nonresponders, and hyaluronan decreased in all patients and in responders.


CONCLUSIONS
Tenascin reflects hepatic fibrogenesis and inflammation which decreases during IFN treatment of children with chronic hepatitis B. TIMP-1 correlates with nonresponse and hyaluronan with histological fibrosis.
Lebensztejn
Dariusz-Marek
DM
IIIrd Department of Pediatrics, Medical University of Bialystok, Poland.
Sobaniec-Lotowska
Maria-Elzbieta
ME
Kaczmarski
Maciej
M
Voelker
Michael
M
Schuppan
Detlef
D
D000293:Adolescent; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D024142:Collagen Type VI / Q000097:blood; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007249:Inflammation; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D019063:Tenascin / Q000097:blood; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood; D016896:Treatment Outcome
D000998:Antiviral Agents; D015415:Biomarkers; D024142:Collagen Type VI; D016326:Extracellular Matrix Proteins; D016898:Interferon-alpha; D019063:Tenascin; D019715:Tissue Inhibitor of Metalloproteinase-1; D006820:Hyaluronic Acid