Expression of apoptosis regulatory markers in the skin of advanced hepatitis-C virus liver patients.
BACKGROUND
Hepatitis-C virus (HCV) infection is considered a major worldwide public health problem with a global prevalence. Maintenance of skin homeostasis requires a delicate balance between proliferation, differentiation, and apoptosis. Meanwhile, it is unclear if there is an altered keratinocyte proliferation/apoptosis balance in advanced liver disease with HCV infection.


OBJECTIVE
This work aimed to evaluate the epidermal thickness and changes in the expression of apoptosis regulatory markers as well as apoptotic index in skin samples of advanced HCV liver patients compared to normal controls.


METHODS
Twenty biopsies were taken from apparently normal skin of advanced HCV liver disease patients, as well as five healthy control subjects. These specimens were used for histometric epidermal measurement, immunohistochemical staining of apoptosis regulatory proteins (Bax, Fas, p53, Caspase-3, Bcl-2, Bcl-xL) as well as the TUNEL technique for detection of apoptotic cells.


RESULTS
The mean epidermal thickness was significantly lower than the control group (P=0.000). There were significant overexpression of pro-apoptotic markers (Bax, Fas, P53, and Caspase-3) in patients (P=0.03, 0.03, 0.003, 0.003 respectively), with increased apoptotic index in HCV liver patients (P=0.002) when compared to normal controls. On the other hand, no statistically significant difference were encountered in the expression of antiapoptotic markers (Bcl-2, Bcl-xL) in HCV patients when compared to normal controls (P=0.5, 0.9, respectively).


CONCLUSIONS
These findings suggest that an alteration in the proliferation/apoptosis balance is present in the skin of HCV liver patients.
Department of Dermatology, STD and Andrology, Faculty of Medicine, Al-Minya University, Al-Minya, Egypt.
Moetaz
M
El-Domyati
Mahmoud
M
Abo-Elenin
Wael Hosam
WH
El-Din
Hossam
H
Abdel-Wahab
Hamza
H
Abdel-Raouf
Tarek
T
El-Amawy
Manal
M
Barakat
Mahmoud
M
Hamdy