title: The Clinical Significance of Serum Apoptotic Cytokeratin 18 Neoepitope M30 (CK-18 M30) and Matrix Metalloproteinase 2 (MMP-2) Levels in Chronic Hepatitis B Patients with Cirrhosis.
abstract: BACKGROUND
  Serum apoptotic cytokeratine 18 neoepitope M30 (CK-18 M30) and matrix metalloproteinase 2 (MMP-2) have been popular markers for detecting liver fibrosis in recent years. CK-18 is a major intermediate filament protein in liver cells and one of the most prominent substrates of caspases during hepatocyte apoptosis. MMP-2 plays an important role in tissue remodeling and repairing processes during physiological and pathological states.
  
  
  OBJECTIVE
  The objective of this study was to investigate the significance of CK-18 M30 and MMP-2 levels for clinical use in patients with chronic hepatitis B (CHB), as well as their sensitivity in determining cirrhotic patients.
  
  
  METHODS
  This study included 189 CHB patients and 51 healthy controls. A modified Knodell scoring system was used to determine the fibrosis level in chronic hepatitis B patients. CK-18 M30 levels were determined with an M30-Apoptosense ELISA assay. MMP-2 levels were determined with the ELISA assay.
  
  
  RESULTS
  The study group consisted of 132 (69.8%) males and 57 (30.2%) females, and the control group consisted of 25 males (49.0%) and 26 females (51%). Patients' CK-18 M30 levels were higher than values of the control group (308 [1-762] vs. 168 [67-287], P=0.001). Serum MMP-2 levels were found to be statistically higher in the patient group with respect to the controls (3.0 [1.1-6.8] vs. 2.0 [1.2-3.4], P=0.001). The highest serum CK-18 M30 and MMP-2 levels were measured in patients with cirrhosis. Serum apoptotic CK-18 M30 levels positively correlated with advanced age, fibrosis stage, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels (P= 0.001, 0.033, 0.001, and 0.001, respectively). Serum MMP-2 levels positively correlated with fibrosis stage, serum ALT, and AST levels (P= 0.001, 0.001, and 0.001, respectively).
  
  
  CONCLUSIONS
  Our study indicated that CK-18 M30 and MMP-2 levels were higher in CHB patients compared to healthy controls and they were in association with significant hepatic fibrosis, especially cirrhosis.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Selcuk University, Faculty of Medicine, Konya, Turkey.
authors.forename: Sua
authors.initials: S
authors.lastname: Sumer
authors.forename: Nazlim
authors.initials: N
authors.lastname: Aktug Demir
authors.forename: Servet
authors.initials: S
authors.lastname: Kölgelier
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cagkan Inkaya
authors.forename: Abdullah
authors.initials: A
authors.lastname: Arpaci
authors.forename: Lütfi
authors.initials: L
authors.lastname: Saltuk Demir
authors.forename: Onur
authors.initials: O
authors.lastname: Ural
keywords: Cirrhosis; Hepatitis B, Chronic; Liver Cirrhosis; Matrix Metalloproteinase 2
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