2 research outputs found
Plasma pituitary adenylate cyclase activating polypeptide (PACAP) levels in chronic hepatitis B patients under lamivudine treatment
Objective Lamivudine is a nucleoside analogue with potent antiviral
activity against hepatitis B virus (HBV). Plasma pituitary adenylate
cyclase activating polypeptide (PACAP) is a multifunctional neuropeptide
that is produced within the lymphoid microenvironment and induces the
production of Th2-type cytokines. The aim of our study was to
investigate the possible alterations of plasma PACAP-38 levels in
chronic hepatitis B (CHB) patients during lamivudine treatment and to
compare them with biochemical, virological and histological data.
Methods Plasma PACAP-38 levels were measured using competitive
radio-immune analysis (RIA) in 25 CHB patients before and after
completion of a 52-week lamivudine treatment period and in 22 healthy
blood donors. Biochemical evaluation was done at baseline and every
three months during treatment. Virological evaluation (HBV-DNA) was
performed at baseline and at weeks 24 and 52 of treatment. Baseline
liver histology was assessed for all patients at the beginning and at
week 52 of the study for histological comparison with the pretreatment
biopsy, according to the Ishak scoring system. Statistical evaluation of
data was done using analysis of variance and Student’s t-test.
Results Virological breakthrough was observed in seven (28%) patients
at week 52 of treatment. Histological improvement was observed in 21
(84%) CHB patients, despite the emergence of
tyrosine-methionine-aspartate-aspartate (YMDD) mutations. Plasma
PACAP-38 levels were significantly lower in CHB patients at baseline
than in healthy blood donors. Significant elevation of plasma peptide
levels was observed in CHB patients after the completion of lamivudine
treatment period, even in the subgroup of those who exhibited YMDD
variants.
Conclusion The elevation of plasma PACAP-38 levels in treated CHB
patients following lamivudine-induced elimination of viraemia suggests a
possible alteration of T-cellular immune response, resulting in
biochemical and histological remission of liver disease, even in
patients who exhibited virological breakthrough. (C) 2003 Lippincott
Williams Wilkins
Autoimmune Pancreatitis with Extreme Elevation of DUPAN-2
An 80-year-old woman was admitted to our hospital with complaints of jaundice and liver dysfunction. She was found to have a high titer of serum IgG4, positive rheumatoid factor and marked elevation of DUPAN-2 (11,148 U/ml). Computed tomography showed swelling of the pancreas, and endoscopic retrograde cholangiopancreatography revealed diffuse irregular narrowing of the main pancreatic duct, which are typical findings of autoimmune pancreatitis. There was no evidence of malignancy. Administration of 30 mg/day of prednisolone was started. Computed tomography showed significant regression in the size of the pancreas, and the stenosis of the main pancreatic duct was improved on ERCP. The serum level of DUPAN-2 was also markedly decreased after the treatment