الفهرس 
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Abstract
Hepatitis C is a blood born viral illness responsible for significant morbidity and mortality throughout the world. Millions of peoples globally are infected with the HCV, the majority of whom will establish chronicity with long term complications such as Cirrhosis, liver failure and hepatocellular carcinoma (HCC).
T2DM is a common metabolic disorder affecting over 150 million people. The disease is characterized by, in addition to defective insulin secretion, insulin resistance and increase hepatic glucose production which cause hyperglycemia.
Tissue factor (CD 142) is a 43 – 46 kDa, single –chain, integral plasma membrane glycoprotein of the cytokine- receptor superfamily; it is the main physiological initiator of normal blood coagulation. The 263 – amino acid mature protein has three distinct domains: an amino-terminal extracellular domain (219 amino acids), a transmembrane domain (23 amino acids), which a cytoplasmic carboxyterminal domain (21 amino acids)
Beside TF role in initiation the hemostasis, also acts as a key link between coagulation, inflammatory processes and immune responses. Activated monocytes show high TF expression and, thus, their accumulation in the liver results in intensification of the inflammatory process and liver damage.
The aim of this study was to identify a possible role for TF in pathogenesis of hepatic damage in patients with HCV-related cirrhosis with type 2 diabetes mellitus T2DM.
This study was carried out in Clinical Pathology Department, Faculty of medicine, Menoufia University .The patients were recruited from Internal Medicine .The study included 80 subjects divided into 3 groups: group I consisted of 30HCV-related cirrhotic patients with diabetes; 20 males and 10 females their ages with Mean ± SD (54.50 ± 6.37) year, group II consisted of 30HCV-related cirrhotic patients; 21 males and 9females, their ages with Mean ± SD (53.63 ± 7.17) years and group III consisted of 20 apparently healthy subjects, served as a control group, males and females their ages with Mean ± SD (51.55 ± 5.72) years.
All participants were submitted to the following; history taking, clinical examination and laboratory investigations that will include complete blood count, liver function tests, fasting and postprandial blood glucose levels, glycated hemoglobin (HBA1c), Lipid profile and abdominal ultrasound. Also, CD14, CD142 and costimulatory CD86 on peripheral blood monocytes were identified by flowcytometry analysis.
The result of this study revealed that:
Tissue factor (CD142) expression in the studied groups: Naive monocytes expressed TF (CD142) at low levels however those levels increased significantly upon stimulation with LPS (p < 0.001). Monocytic CD142+ was significantly higher in cirrhotic patients with diabetes compared to the other 2 groups for cirrhosis and controls (p < 0.001). In addition patients with cirrhosis alone had significantly higher monocyte TF compared to healthy control.These results were demonstrated prior to and after stimulation with LPS, data not shown.
Study of costimulatory molecule CD86 expression the expression of CD86 was significantly higher in diabetic cirrhotic patients compared to cirrhotic non diabetic and compared to healthy controls. There was a positive correlation between TF expression