title: Hepatocellular MxA protein expression supports the differentiation of recurrent hepatitis C disease from acute cellular rejection after liver transplantation.
abstract: Differentiation of recurrent hepatitis C virus (HCV) disease from acute cellular rejection (ACR) following liver transplantation can be difficult. Previously, we have found that MxA protein, a specific and sensitive marker for type 1 interferon production, is strongly expressed in chronic HCV disease. Here, we investigate MxA expression as a marker for recurrent HCV disease in the livers of 14 adult HCV patients who underwent liver transplantation. Serial liver biopsies available for 12 of these patients were stained for MxA protein and scored using a semi-quantitative approach. Hepatocellular MxA protein levels were significantly up-regulated (p = 0.025) in recurrent HCV disease in comparison to ACR. In biopsies that showed histological changes consistent with recurrent HCV disease, strong hepatocellular MxA staining was present in 14/18 (78%). In the liver biopsies with histological evidence of ACR, strong MxA hepatocellular staining was present in only three of 10 (30%). Thus, assessment of hepatocellular MxA protein expression can contribute to the differential diagnosis of ACR and recurrent HCV disease following liver transplantation. In conclusion, analysis of intrahepatic MxA levels has the potential to reduce the inappropriate use with high-dose pulsing of steroids post-operatively.
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. Gerry.MQuillan@health.wa.gov.au
authors.forename: Gerry C
authors.initials: GC
authors.lastname: MacQuillan
authors.forename: W Bastiaan
authors.initials: WB
authors.lastname: de Boer
authors.forename: Jane E
authors.initials: JE
authors.lastname: Allan
authors.forename: Michael A
authors.initials: MA
authors.lastname: Platten
authors.forename: William D
authors.initials: WD
authors.lastname: Reed
authors.forename: Gary P
authors.initials: GP
authors.lastname: Jeffrey
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D019204:GTP-Binding Proteins / Q000378:metabolism*; D006084:Graft Rejection / Q000175:diagnosis* / Q000209:etiology; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000175:diagnosis*; D022781:Hepatocytes / Q000378:metabolism / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000378:metabolism*; D016031:Liver Transplantation / Q000009:adverse effects; D008875:Middle Aged; D064547:Myxovirus Resistance Proteins; D011184:Postoperative Period; D012008:Recurrence; D019562:Viral Load
chemical_list: C579071:MX1 protein, human; D064547:Myxovirus Resistance Proteins; D019204:GTP-Binding Proteins