Role of immunity and endogenous antimicrobial peptides in the pathogenesis of chronic hepatitis C

Aim. To study the immunological parameters and the concentration of antimicrobial peptides defensins, neutrophil elastase, endotoxin and lipopolysaccharide-binding protein in patients with chronic hepatitis C, and to identify the relationship between these changes and their role in the pathogenesis of the disease. Methods. Blood plasma of 64 patients with chronic hepatitis C, including 31 patients with uncomplicated course of the disease (the first group) and 33 patients with chronic hepatitis C, accompanied by a bacterial infection (pneumonia, the second group) was studied. The concentration of total, direct and indirect bilirubin was determined by Endrashik method, alanine aminotransferase and aspartate aminotransferase - by Reitman-Frankel method, γ-glutamyl transferase enzyme activity and total protein level - using «Diasys» (Germany) commercial kits. Defensin, endotoxin, neutrophil elastase and lipopolysaccharide-binding protein levels were determined by ELISA using «Hycult Biotechnology» (The Netherlands) kit. To assess the state of cellular and humoral immunity, lymphocytes subpopulations were determined by indirect surface immunofluorescence reaction using murine monoclonal antibodies to CD3+, CD4+, CD8+, CD14+, CD16+, CD25+ lymphocyte antigens. Results. Immunological parameters changed unidirectionally in both groups of patients. The degree of the antimicrobial peptides increase was higher in the second group, which is probably due to the presence of bacterial factor, in addition to the virus. The number of CD3+-lymphocytes negatively correlated with the level of α-defensins (p <0.005) in the first group of patients. A strong positive correlation of the CD8+-cells count and elafin level (p <0.001) and elastase (p <0.001) was revealed. The number of CD16+-cells showed a strong positive relationship only with elastase level (p <0.001). Conclusion. The obtained data justify the use of defensin, neutrophil elastase, endotoxin and lipopolysaccharide binding protein as additional biomarkers for assessing the inflammatory process in the liver at viral and bacterial infections.

defensin, endotoxin, neutrophil elastase, chronic hepatitis C, lymphocytes, elafin