Viral Hepatitis
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 7, 2006; 12(21): 3338-3343
Published online Jun 7, 2006. doi: 10.3748/wjg.v12.i21.3338
Matrix-derived serum markers in monitoring liver fibrosis in children with chronic hepatitis B treated with interferon alpha
Dariusz Marek Lebensztejn, Maria Elżbieta Sobaniec-Lotowska, Maciej Kaczmarski, Michael Voelker, Detlef Schuppan
Dariusz Marek Lebensztejn, Maciej Kaczmarski, IIIrd Department of Pediatrics, Medical University of Bialystok, Poland
Maria Elżbieta Sobaniec-Lotowska, Department of Clinical Pathomorphology, Medical University of Bialystok, Poland
Michael Voelker, Bayer Research, Krefeld, Germany
Detlef Schuppan, Department of Medicine I, University of Erlangen-Nuernberg, Germany, and Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States
Supported by the Interdisciplinary Center for Clinical Research (IZKF) of the University of Erlangen-Nuernberg, Germany
Correspondence to: Detlef Schuppan, MD, PhD, Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, United States. dschuppa@bidmc.harvard.edu
Telephone: +1-617-6678377 Fax: +1-617-6672767
Received: November 2, 2005
Revised: November 28, 2005
Accepted: February 18, 2006
Published online: June 7, 2006
Abstract

AIM: To evaluate prospectively 4 selected serum fibrosis markers (tenascin, hyaluronan, collagen VI, TIMP-1) before, during and 12 mo after IFN treatment of children with chronic hepatitis B.

METHODS: Forty-seven consecutive patients with chronic hepatitis B (range 4-16 years, mean 8 years) underwent IFN treatment (3 MU tiw for 20 wk). Fibrosis stage and inflammation grade were assessed in a blinded fashion before and 12 mo after end of treatment. Serum fibrosis markers were determined using automated assays.

RESULTS: IFN treatment improved histological inflammation but did not change fibrosis in the whole group or in subgroups. Only hyaluronan correlated significantly with histological fibrosis(r = 0.3383, P = 0.021). Basal fibrosis markers did not differ between responders (42.5%) and nonresponders(57.5%). During IFN treatment only serum tenascin decreased significantly in the whole group and in nonresponders. When pretreatment values were compared to values 12 mo after therapy, TIMP-1 increased in all patients and in nonresponders, and hyaluronan decreased in all patients and in responders.

CONCLUSION: Tenascin reflects hepatic fibrogenesis and inflammation which decreases during IFN treatment of children with chronic hepatitis B. TIMP-1 correlates with nonresponse and hyaluronan with histological fibrosis.

Keywords: Biopsy; Collagen VI; Fibrogenesis; Fibrosis; Hepatitis B virus; Hyaluronan; Serum marker; Tenascin; TIMP-1