Serum level of interleukin-10 with its gene polymorphism can be predictors of response to treatment in Egyptian patients with chronic hepatitis C virus

Purpose: The aim of this study was to demonstrate the role of interleukin-10 (IL-10) gene polymorphism and its serum level in predicting response to treatment in patients with chronic hepatitis C virus.Patients and methods: This study was carried out on 35 Egyptian patients with chronic HCV (Hepatitis C Virus) and 15 age- and sex-matched healthy subjects as control. They were divided as follows: Group I: 35 chronic HCV patients. They were subdivided according to their response to combination therapy of pegylated interferon alpha 2b and ribavirin into: Group I (a): 21 responder patients. Group I (b): 14 non responder patients. Group II: 15 healthy subjects as a control group. IL-10 serum level was assessed by ELISA (Enzyme Linked Immunosorbent Assay) before, during and after treatment. IL-10 gene polymorphism and genotype were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results: A significant higher level of serum IL-10 was detected in HCV patients compared to the control group. A significant reduction was detected during treatment and a persistent decrease was found in patients with SVR. Low serum level of IL-10 pretreatment was associated with high treatment response. High pretreatment of the serum level of IL-10 was associated with the severity of chronic necroinflammation and non  response to treatment. A positive correlation was found between IL-10 and serum ALT. The frequency of IL-10 592 genotype polymorphism was higher in HCV patients compared to control. A significant higher frequency of the IL-10 592 C/C polymorphism was found in the responder group compared to non responder. No correlation was observed between IL-10 polymorphism and liver histopathology.Conclusion: Serum IL-10 level pretreatment is useful for predicting treatment response in HCV patients. IL-10 may be a useful marker to assess necroinflammation and to monitor the evolution of liver damage. IL-10 gene polymorphism has no relation to liver histopathology. IL-10 592 C/C genotype was more frequent in responder patients

NT-proBNP as Early Marker of Subclinical Late Cardiotoxicity after Doxorubicin Therapy and Mediastinal Irradiation in Childhood Cancer Survivors

Background. Childhood cancer survivors treated with anthracyclines and mediastinal irradiation are at risk for late onset cardiotoxicity. Aims of the Study. To assess the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) as early predictors of late onset cardiotoxicity in asymptomatic survivors of childhood cancer treated with doxorubicin with or without mediastinal irradiation. Methods. A cross-sectional study on 58 asymptomatic survivors of childhood cancer who received doxorubicin in their treatment protocols and 32 asymptomatic Hodgkin’s lymphoma survivors who received anthracycline and mediastinal irradiation. Levels of NT-proBNP, TDI, and conventional echocardiography were determined. Results. Thirty percent of survivors had abnormal NT-proBNP levels. It was significantly related to age at diagnosis, duration of follow-up, and cumulative dose of doxorubicin. TDI detected myocardial affection in 20% more than conventional echocardiography. Furthermore, abnormalities in TDI and NT-pro-BNP levels were more common in Hodgkin lymphoma survivors receiving both chemotherapy and radiotherapy. Conclusions. TDI could detect early cardiac dysfunction even in those with normal conventional echocardiography. Measurement of NT-proBNP represents an interesting strategy for detecting subclinical cardiotoxicity. We recommend prospective and multicenter studies to validate the role of NT-proBNP as an early marker for late onset doxorubicin-induced cardiotoxicity