REACTIVE OXYGEN SPECIES AND THEIR EFFECT ON HEPATIC FIBROSIS IN CHILDREN WITH CHRONIC HEPATITIS C.

A.M.Chrobot. M.Czerwionska-Szaflarska, A.Chrobot

Department of Paediatrics, Allergology and Gastroenterology, University School of Medical Science, Bydgoszcz, Poland

OBJECTIVE: Precise mechanisms by which HCV produces liver damage are little known. It's possible that some interactions between viral infection and reactive oxygen species exist. Lipid peroxidation products such as malondialdehyde (MDA) rising during inflammation have effects on hepatic stellate cells to promote pathologic fibrogenesis in the liver. The aim of the study was to analyse erythrocyte malondialdehyde (MDA) concentration and its influence on stage of hepatic fibrosis and to determine the state of antioxidant barrier in children with chronic viral hepatitis C.

METHODS: The study included 50 children with HCV [anti-HCV (+), HCV-RNA (+)] between 4-18 years of ages with histopathologicaly confirmed chronic active hepatitis. All the patients had a biopsy sample compatible with modified Scheuer classification (F=0 - no fibrosis, F=4 - cirrhosis). Comparative group made 50 children with coeliac disease on gluten free diet. MDA was measured spectrophotometricaly by the reaction of thiobarbituric acid. Catalase ( CAT) was assayed also spectrophotometricaly by Bear and Sizer method and superoxide dismutase ( SOD ) by Misra - Fridovich method.

RESULTS: Erythrocyte MDA concentration was significantly higher in patients with HCV( 44,91 ± 19,34 nM/gHb) as compared with control group (29,04 ± 12,60 nM/gHb) (p<0,001). CAT and SOD activities were lower in HCV group (CAT = 39,15 + 15,35 IU/gHb), (SOD = 953,42 ± 227,87 U/gHb) as in control group (CAT = 51,92 ± 15,27 IU/gHb), (SOD = 1161,80 ± 399,56 U/gHb) (p<0,05). MDA in children with F<1 in histopathological picture was 42,92 nM/gHb ± 18,70 (n=43) and it was much lower than in children with F ³1 (57,11 nM/gHb ± 18,68)(n=7). (p<0,05).

CONCLUSIONS: Lipid peroxidation occurs in chronic hepatitis C in children and oxidative damage is demonstrated by increased levels of MDA. Antioxidant defence has lower efficiency and lipid peroxidation is correlated with stage of fibrosis.