title: Diabetes worsening of hepatitis C cirrhosis: are alterations in monocytic tissue factor (CD 142) is the cause?
abstract: BACKGROUND & AIM. The mechanisms by which type 2 diabetes mellitus (T2DM) worsen liver function are not yet established. Tissue factor (TF) is a protein that participates in hemostatic, immune and inflammatory processes. To test the hypothesis that T2DM contributes to clinical outcome through changes of TF expression on monocytes and to investigate the association between antidiabetic therapies and monocytic TF expression in HCV-related cirrhotic patients with T2DM. MATERIAL AND METHODS. In HCV-related cirrhotic patients (139 diabetics and 130 non diabetics) compared with 100 matched diabetic patients and 100 Controls; the flowcytometric analysis of CD14, TF (CD142), costimulatory molecules; CD86 and HLA-DR on monocytes were determined. RESULTS. Cirrhotic patients with T2DM have increase in the expression of monocytic TF and CD86 in comparison with cirrhotic non-diabetic, diabetic and healthy control; which increase significantly with increase of the stage of the Child-Pugh score. The expression of HLA-DR is significantly lower in cirrhotic patients than controls. Albeit, there were no significant differences in the HbA1c levels between the three groups, the use of exogenous insulin were associated with significantly higher monocytic TF expression than those in sulphonylurea and insulin sensitizer group (P < 0.03 for both). CONCLUSIONS. The monocytic TF as a significant link connecting inflammatory and immunological phenomena can partially explain a lot of events in HCV- related cirrhotic patients with T2DM. The use of exogenous insulin was associated with significantly higher TF expression than sulphonylurea and insulin sensitizer. Future target therapy against TF may be beneficial for T2DM cirrhotic patients.
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Mona A Abu
authors.initials: MA
authors.lastname: El Makarem
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Eslam
authors.affiliation: Flow Cytometry Lab, South Egypt Cancer Institute, Assuit University, Assuit, Egypt.
authors.forename: Douaa
authors.initials: D
authors.lastname: Sayed
authors.affiliation: Department of Biochemistry, Assuit University, Assuit, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shawkat
authors.affiliation: Department of Biochemistry, Assuit University, Assuit, Egypt.
authors.forename: Naglaa K
authors.initials: NK
authors.lastname: Idriss
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Elwy M
authors.initials: EM
authors.lastname: Soliman
authors.affiliation: Department of clinical pathology, Assuit University, Assuit, Egypt.
authors.forename: Tahra
authors.initials: T
authors.lastname: Sherif
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Ragaa
authors.initials: R
authors.lastname: Abdelshaheed
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: Abdelhailm
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Sahrawi
authors.affiliation: Department of Internal Medicine, Minia University, Minia, Egypt.
authors.forename: Sahar
authors.initials: S
authors.lastname: Elheney
mesh_terms: D000328:Adult; D051940:B7-2 Antigen / Q000378:metabolism*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry; D006684:HLA-DR Antigens / Q000378:metabolism*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011446:Prospective Studies; D013925:Thromboplastin / Q000378:metabolism*
chemical_list: D051940:B7-2 Antigen; C497964:CD86 protein, human; D006684:HLA-DR Antigens; D007004:Hypoglycemic Agents; D007328:Insulin; D018950:Lipopolysaccharide Receptors; D013925:Thromboplastin