Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Konstantinides Polydoros
Dissertation committee:
Σπυρίδων Π. Ντουράκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ιωάννης Κοσκίνας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Βασιλόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σπήλιος Μανωλακόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αιμιλία Χατζηγιάννη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αλεξάνδρα Αλεξοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μέλανι Ντόιτς, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η ιντερλευκίνη-17Α και ο ενεργοποιητικός παράγοντας των Β λεμφοκυττάρων σε ασθενείς με χρόνια ηπατίτιδα C και μικτή κρυοσφαιριναιμία. Επιδράσεις της αντιιικής θεραπείας και συσχετίσεις με τη βιταμίνη D.
Translated title:
Interleukin-17A and B-cell activating factor in patients with chronic hepatitis C virus with and without asymptomatic mixed cryoglobulinemia. Effects of antiviral treatment and correlations with vitamin D.
Summary:
Background: Several studies have provided conflicting results regarding the immune responses in chronic hepatitis C (CHC) patients with mixed cryoglobulinemia (MC). The importance of B-cell activating factor (BAFF) in MC has been described, but the role of interleukin (IL)-17A is less clear.
Aim of the Study: The main objectives were to determine the levels of BAFF and IL-17A cytokines in patients with CHC with or without MC, and to investigate their kinetics during antiviral treatment with pegylated interferon-α/ribavirin and 6 months after the end of it. In addition, the aim was to evaluate the possible correlation of cytokines with vitD levels, the degree of hepatic fibrosis and the response to antiviral therapy. Furthermore, the results were correlated with demographic and laboratory data of the patients under study.
Methods: Serum concentrations of IL-17A, BAFF and 25-OH vitamin D were measured in 34 CHC patients at baseline, end of treatment, and 6 months post-treatment with pegylated interferon-α and ribavirin, versus 12 healthy controls.
Results: Thirty-four patients (20 male, mean age 40.7±9.2 years, 12 of genotype 1 or 4, 22 of genotype 2 or 3) were included, of whom 64.7% achieved a sustained virological response (SVR). MC was detected in 52.9% of the patients. Higher levels of both cytokines were found in patients with MC compared to those without. Patients who achieved SVR had higher pretreatment IL-17A and lower BAFF levels compared to those without SVR. IL-17A was downregulated during and following treatment in responders, whereas upregulation was observed in non-responders. CHC patients demonstrated low vitamin D levels compared to HC. Moreover, the changes in IL-17A over the treatment period were significantly associated with vitamin D changes (β=-0.04, SE=0.02, P=0.046). No difference in IL-17A, BAFF and vitamin D values was seen between patients with cirrhosis (n=14) and those without.
Conclusions: CHC patients with asymptomatic MC have increased levels of IL-17A and BAFF. IL-17A levels decline significantly while BAFF increases during treatment in responders. An interplay between IL-17A and vitamin D concentrations was revealed during the antiviral treatment.
Main subject category:
Health Sciences
Keywords:
Interleukin 17A, B-cell activating factor, Vitamin D, Chronic hepatitis C, Mixed cryoglobulinemia
Number of references:
195
