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Abstract
HCV represents a public health problem all over the world, and according to WHO epidemiology report, endemic areas such as EGYPT, more than 10% of the population are infected.
Liver biopsy remains the gold standard measure in assessment the liver disease injury, but it is invasive with high risk of serious complications. Aminotransferases are not good markers for reflecting the activity grading and the fibrosis stage of liver tissue biopsy. So there is a strong need for reliable non invasive methods to detect HCV activity and Liver damage, Caspase-3 activity was used for assessment the histopathological activity in chronic liver disease.
Caspases are enzymes (proteases) involved in apoptosis. Increasing their levels is associated with liver injury, so assessment of Caspase activity may be a more sensitive measure.
This study aimed to detect serum Caspase-3 activity (one of the caspases apoptosis executioners) in 3 groups’ patients with chronic HCV infection in comparison to the histological findings in liver biopsies.
This study was conducted on 20 normal volunteers served as control and 60 HCV patients divided into 3 groups, group I chronic active hepatitis, group II cirrhotic, group III hepatocellular carcinoma (HCC).
They were all evaluated in terms of (clinical, biochemical, serological and histopathological methods)
The study showed significant higher values of the serum caspase levels in the diseased patients in comparison to the control group.
This study showed significant correlation between serum caspase-3 activity and serum aminotransferases except for the patients with group III hepatocellular carcinoma.
Caspase-3 activity was significantly correlated to the activity grading of the liver biopsy assessed by Metavir scoring system, but not to the fibrosis staging.
Although caspase-3 activity was not correlated to fibrosis staging but their increasing denoted higher grade of fibrosis.
The assessment of the serum caspase-3 activity alone is not a sensitive measure for liver pathology, so suggestion for measuring caspase-3 in the liver biopsy itself or the other caspase cascade as 6,7,8,9and 10, also follow up with liver biopsy may be recommended.
Caspase may also be useful for more researches in blocking their actions, for slowing down the cells destruction through novel pharmacological caspases inhibitors in clinical trials to prevent HCV associated liver injury.