title: Caspase-cleaved fragments of cytokeratin 18 in patients with chronic hepatitis B.
abstract: BACKGROUND
  During hepatocyte apoptosis, intermediate filament protein cytokeratin 18 is cleaved by caspases at Asp396 which can be specifically detected by the monoclonal antibody M30 (M30-antigen). In this study, we sought to determine whether serum M30-antigen levels can serve as a useful biomarker of liver injury in the clinical spectrum of HBV infection.
  
  
  METHODS
  Serum M30-antigen levels were measured in inactive HBV carriers (n=54), patients with HBeAg-negative chronic hepatitis B (CHB, n=47), patients with HBeAg-positive CHB (n=42) and healthy controls (n=29). All subjects were treatment-naïve.
  
  
  RESULTS
  There were significant differences in serum M30-antigen levels across the study groups (P<0.001; Kruskal-Wallis test). Post hoc analyses revealed that M30-antigen levels did not differ significantly between inactive HBV carriers (median 109.6 U/L) and healthy controls (median 106.1 U/L). However, both patients with HBeAg-negative (CHB, median 182.9 U/L, P<0.001) and HBeAg-positive CHB (median 158.3 U/L, P<0.001) had significantly higher levels of M30-antigen compared with inactive HBV carriers.
  
  
  CONCLUSIONS
  Hepatocyte apoptotic activity--as reflected by serum M30-antigen levels--is increased in chronic active hepatitis B, but is not associated with the HBeAg status. In contrast, apoptosis does not appear to be a prominent feature of inactive HBV carriers.
authors.affiliation: Institute of Gastroenterology, Marmara University, Istanbul, Turkey, Maltepe, Istanbul 34840, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Eren
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yilmaz
authors.forename: Sukran
authors.initials: S
authors.lastname: Kose
authors.forename: Filiz Ture
authors.initials: FT
authors.lastname: Ozdemir
authors.forename: Oya
authors.initials: O
authors.lastname: Yonal
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kurt
authors.forename: Osman
authors.initials: O
authors.lastname: Ozdogan
authors.forename: Erol
authors.initials: E
authors.lastname: Avsar
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D020169:Caspases / Q000378:metabolism*; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood*; D006801:Humans; D053538:Keratin-18 / Q000737:chemistry* / Q000378:metabolism*; D008099:Liver / Q000293:injuries / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood* / Q000276:immunology; D012372:ROC Curve
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D053538:Keratin-18; D010446:Peptide Fragments; D020169:Caspases