Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis.

Background: The effect of hepatitis B virus (HBV) infection on fatty liver disease is unclear.. Objectives: The aim of this study was to investigate the viral and host causes of fatty liver in chronic hepatitis B (CHB) patients. This study included 88 CHB patients of which 17 were not treated. Liver biopsy was performed in each patient. Group 1 included those with hepatic steatosis (n=28) and group 2 those without hepatic steatosis. The groups were compared in terms of age, body mass index (BMI), Homeostasis Model Assessment- Insulin Resistance (HOMA-IR), viral load, biochemical parameters and histological findings. Patients in group 1 were subdivided according to the degree of steatosis as follows: grade 1 (15 patients, 53.6%), grade 2 (6 patients, 21.4%),and grade 3 (7 patients, 25%). Results: In group 1 (n=28), mean age, BMI, cholesterol, and HOMA-IR were found to be significantly higher than in group 2 (n=60). There were no significant differences in the positivity of viral load, HbeAg, treatment, fibrosis and other laboratory parameters between the two groups. HOMA-IR was the only independent predictive factor of liver steatosis in patients with CHB in logistic regression analysis. Conclusion: Hepatic steatosis in CHB patients was associated with host metabolic factors

Serum Beta 2-Microglobulin As A Biomarker in Inflammatory Bowel Disease

AIM: To investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of inflammatory bowel disease (IBD). METHODS: Overall, 78 IBD patients and 30 healthy controls were enrolled in the study. We examined B2-M serum levels in 43 ulcerative colitis (UC) patients, 35 with Crohn's disease (CD) and 30 control subjects, using an enzymatic method. Patients were divided into two groups according to two disease types: active and in remission. Subjects were also divided into two subgroups according to extent of the disease: left-side and pancolitis for UC and ileitis and ileocolitis for CD. All groups were compared for mean serum B2-M levels and also examined to see whether there was a correlation between serum B2-M levels and other inflammatory markers. RESULTS: The mean serum B2-M levels in the control group, UC and CD were 1.71, 2.41 and 2.24 respectively. B2-M values >= 1.96 mg/L had a 62% sensitivity, 76% specificity, a 79% positive predictive value, and a 58% negative predictive value for UC patients. B2-M values >= 1.70 mg/L had 80% sensitivity, 53% specificity, 66% positive predictive value, and 69% negative predictive value for CD patients. Mean B2-M values were significantly higher in ulcerative colitis and Crohn's disease patients than in healthy controls (UC 2.41 +/- 0.87 vs 1.71 +/- 0.44, P = 0.002; CD 2.24 +/- 1.01 vs 1.71 +/- 0.44, P = 0.033). Also, mean B2-M values were significantly higher in active disease when compared to patients in remission (UC 2.66 +/- 0.92 vs 1.88 +/- 0.41, P = 0.004; CD 2.50 +/- 1.15 vs 1.73 +/- 0.31, P = 0.033). The difference between groups (UC and CD) in terms of serum B2-M levels was statistically insignificant (2.41 +/- 0.87 vs 2.24 +/- 1.01, P > 0.05 respectively). CONCLUSION: Serum B2-M levels may be used as an activity parameter in IBD. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.WoSScopu

Psoriatic colitis mimicking ulcerative proctitis in an elderly patient

WOS: 000305259700046PubMed ID: 22884084

The Colonic Tissue Levels of Tlr2, Tlr4 And Nitric Oxide in Patients with Irritable Bowel Syndrome

Objective Irritable bowel syndrome (IBS) is a highly prevalent and debilitating functional disorder. The toll-like receptors (TLRs) are a family of pathogen-recognition receptors in the innate immune system. In the present study we aimed to investigate the TLR2, TLR4 and nitric oxide (NO) levels in patients with IBS. Methods Fifty-one IBS patients and 15 healthy controls were included in the present study. Colonic tissue levels of TLR2, TLR4 and NO were detected using an enzyme-linked immunosorbent assays (ELISA) and through biochemical methods. Results The colonic tissue levels of TLR4 and NO were significantly higher in IBS patients than in healthy controls. A subgroup analysis, which was based on the presence of diarrhea and constipation, showed that TLR2 levels were significantly higher among individuals with diarrhea-predominant IBS than among constipation-predominant IBS patients and healthy controls. The TLR4 levels were significantly higher in the diarrhea-predominant IBS patients and constipation-predominant IBS patients than in comparison healthy controls. The colonic tissue levels of NO were higher in the constipation-predominant IBS patients than in the diarrhea-predominant IBS patients and healthy controls. Conclusion In the present study we found that the colonic tissue levels of TLR and NO were elevated in IBS patients. Our results support the presence of a degree of immune dysregulation and oxidative stress in patients with IBS.Wo

Serum Toll-Like Receptor-2, Toll-Like Receptor-4 Levels In Patients With Hbeag-Negative Chronic Viral Hepatitis B

Toll-like receptors (TLRs) may play an important role in hepatitis-B pathogenesis. However, serum TLR-2 and TLR-4 levels and their association with serum liver enzymes, hepatitis B virus (HBV) DNA, quantitative HBsAg levels, and liver biopsy findings, are unknown. A total of naive 40 HBeAg (-) chronic hepatitis B (CHB) patients and 20 healthy control subjects were recruited in this study. Liver tests, HBV DNA, serum TLR2 and TLR-4, and quantitative HBsAg levels were evaluated among all groups. The relationship among TLR-2, TLR-4, quantitative HBsAg levels and liver tests, and liver histological findings were investigated with correlation analysis. Serum TLR-2 and TLR-4 levels in HBeAg (-) CHB patients were higher than in the control group. There was a positive correlation between serum TLR-2, TLR-4, and HBV DNA and ALT levels. We have further demonstrated that serum TLR-2 levels are correlated with AST and quantitative HBsAg levels. However, TLRs levels were not linked to the liver biopsy findings. TLR can have an important role in hepatitis B pathogenesis. Liver injury in CHB may cause elevated TLR-2 and TLR-4 levels.Wo