Inflammation response and liver stiffness: predictive model of regression of hepatic stiffness after sustained virological response in cirrhotics patients with chronic hepatitis C

Author(s)

Braz, Aline Marcia Marques ^{[1, 2]} ; Winckler, Fernanda Cristina ^[1] ; Binelli, Larissa Sarri ^[2] ; Chimeno, Luis Guilherme ^{[2, 3]} ; Lopes, Lia Beatriz Mantovani ^{[2, 3]} ; Lima, Rodrigo Santos ^[4] ; Simoes, Rafael Plana ^{[3, 5]} ; Grotto, Rejane Maria Tommasini ^{[3, 5, 4, 6]} ; Golim, Marjorie de Assis ^{[2, 3]} ; Silva, Giovanni Faria ^{[1, 3]}

Affiliation

^[1] Sao Paulo State Univ UNESP, Botucatu Med Sch, Dept Clin Med, Grad Program Pathophysiol Clin Med, Botucatu, SP - Brazil

^[2] Botucatu Med Sch, Clin Hosp, Appl Biotechnol Lab LBA, Flow Cytometry Lab, Av Prof Mario Rubens Guimaraes Montenegro S-N, Botucatu, SP - Brazil

^[3] Sao Paulo State Univ UNESP, Botucatu Med Sch, Grad Program Res & Dev Med Biotechnol, Botucatu, SP - Brazil

^[4] Sao Paulo State Univ UNESP, Botucatu Med Sch, Dept Pathol, Grad Program Pathol, Botucatu, SP - Brazil

^[5] Sao Paulo State Univ UNESP, Fac Agron Sci, Dept Biotechnol & Bioproc Engn, Botucatu, SP - Brazil

^[6] Botucatu Med Sch, Clin Hosp, Appl Biotechnol Lab LBA, Mol Biol Lab, Botucatu, SP - Brazil

• Document type: Journal article
• Source: CLINICAL AND EXPERIMENTAL MEDICINE; v. 21, n. 4, p. 587-597, NOV 2021.
• Web of Science Citations: 1

Abstract

Cirrhotic patients with chronic hepatitis C should be monitored for the evaluation of liver function and screening of hepatocellular carcinoma even after sustained virological response (SVR). The stage of inflammatory resolution and regression of fibrosis is likely to happen, once treatment and viral clearance are achieved. However, liver examinations by elastography show that 30-40% of patients do not exhibit a reduction of liver stiffness. This work was a cohort study in cirrhotic patients whose purpose was to identify immunological factors involved in the regression of liver stiffness in chronic hepatitis C and characterize possible serum biomarkers with prognostic value. The sample universe consisted of 31 cirrhotic patients who underwent leukocyte immunophenotyping, quantification of cytokines/chemokines and metalloproteinase inhibitors in the pretreatment (M1) and in the evaluation of SVR (M2). After exclusion criteria application, 16 patients included were once more evaluated in M3 (like M1) and classified into regressors (R) or non-regressors (NR), decrease or not >= 25% stiffness, respectively. The results from ROC curve, machine learning (ML) and linear discriminant analysis showed that TCD4 + lymphocytes (absolute) are the most important biomarkers for the prediction of the regression (AUC = 0.90). NR patients presented levels less than R of liver stiffness since baseline, whereas NK cells were increased in NR. Therefore, it was concluded that there is a difference in the profile of circulating immune cells in R and NR, thus allowing the development of a predictive model of regression of liver stiffness after SVR. These findings should be validated in greater numbers of patients. (AU)

• FAPESP's process: 16/25416-3 - Influence of the immunological profile on sustained virological response of patients with chronic Hepatitis during therapy with direct acting antivirals
• Grantee: Giovanni Faria Silva
• Support Opportunities: Regular Research Grants