HCV infection in haemodialysed patients: a role for serum IL-10 and TGF-beta1 in liver damage?
BACKGROUND
Hepatitis C virus (HCV) infection is often clinically silent in haemodialysed (HD) patients and their immune response may modulate liver damage in HCV infection. IL-10 and TGF-beta1 could play a role in this setting as, IL-10 down-regulates hepatic fibrosis, while TGF-beta1 is a pro-fibrotic cytokine.


OBJECTIVE
To evaluate the role of IL-10 and TGF-beta1 in HD/HCV+ patients.


METHODS
71 HD/HCV+ patients (58 with normal [HD/HCV-N] and 13 with high serum transaminases [HD/HCV-H]), 40 non-uremic patients with chronic hepatitis C (HCV+), 56 HD anti-HCV- patients and 20 healthy volunteers (H).


METHODS
IL-10 and TGF-beta1 serum levels were assessed using ELISA tests. Liver histology was assessed by Ishak's score.


RESULTS
IL-10 serum levels were significantly higher in HD patients, both HCV+ (3.7+/-0.4 pg/ml; p<0.01) and HCV- (3.8+/-0.8 pg/ml; p<0.05) than in non-uremic HCV patients (2.3+/-0.4 pg/ml). Among the HD/HCV+ patients, IL-10 serum levels were similar in HD/HCV-N and in HD/HCV-H patients. Among the HD/HCV+ patients, IL-10 serum levels were similar in those with moderate histological damage compared to those with mild damage. TGF-beta1 serum levels were significantly lower in HD patients, both HCV+ (4.6+/-0.9 ng/ml) and HCV- (6.0+/-0.9 ng/ml) than in non-uremic HCV+ patients (8.1+/-1.1 ng/ml; p<0.001 and p<0.01, respectively), but similar to the values found in H (5.3+/-0.9 ng/ml; p=n.s.). No correlation was seen between IL-10 and TGF-beta1 serum levels in any of the groups considered.


CONCLUSIONS
Patients on haemodialysis treatment to have high levels of IL-10, which remain high even when patients are anti-HCV+, whereas the opposite is true of TGF-beta1. The cytokine pattern observed in HD patients is compatible with the hypothesis explaining the relatively benign evolution of HCV-related liver disease in HD patients, and has a pathophysiological role.
Burra
P
P
Gastroenterology Section, Department of Surgical and Gastroenterological Sciences, University of Padova, via Giustiniani 2, 35128 Padova, Italy. burra@unipd.it
Masier
A
A
Morisco
F
F
Di Leo
V
V
Zorzi
M
M
Senzolo
M
M
Marchini
F
F
Guido
M
M
Canova
D
D
Floreani
A
A
Burroughs
A K
AK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012720:Severity of Illness Index; D053773:Transforming Growth Factor beta1 / Q000097:blood*
D053773:Transforming Growth Factor beta1; D016753:Interleukin-10