Publication: Kronik hepatit B hastalarında tiyol-disülfit homeostazı ve iskemi modifiye albümin düzeylerinin değerlendirilmesi / Evaluation of thiol-disulphide homeostasis and ischemia modified albumin levels in chronic hepatitis B patients
Introduction: It is known that oxidative stress caused by reactive oxygen species contributes to progressive liver damage and malignancy in the pathogenesis of chronic hepatitis B infection that affects millions of people in the world. Thiols are organic compounds containing a sulfhydryl group (-SH). Thiol bonds, protective against oxidative stress, produce disulfide bonds when react with reactive oxygen species, which can be reversible and measured. Recent studies have shown that thiol-disulfide homeostasis can change in various chronic diseases. Ischemia modified albümin (IMA) is a form of serum albumin reduced binding affinty to heavy metal ions due to oxidative stress after myocardial ischemia. Recent studies have shown that levels of IMA increased in other chronic diseases. In our literature review we did not find a cohort study of thiol-disulfide homeostasis and IMA levels in chronic hepatitis B patients. In this study we aimed to investigate the changes of thiols-disulfide homeostasis and serum IMA levels in patients with chronic hepatitis B infection compared to the normal population and assesment the benefits in terms of follow-up the patients, medical treatment decision and prognosis. Matherial-Methods: 79 patients diagnosed as chronic HBV infection and 51 healthy controls were included in the study. Demographic data and laboratory results of the patients were recorded. Total thiol, native thiol and disulfide levels were measured by the automated spectrophotometric method described by Erel and Neşelioğlu in serum samples obtained from the patient and healthy control group. SS/SH, SS+SH/SH and SH/SS+SH ratios were calculated from these measured parameters. IMA levels were measured by albumin cobalt binding test. Results: Native thiol and total thiol levels were significantly lower in the patient group (respectively; p=0,0001, p=0,002). There was no statistical significance detected between patient and control groups in terms of disulphide levels (p=0,6). In addition, no statistical significance was detected between the groups in disulfide/native thiol, disulfide/total thiol, native thiol/total thiol ratio. IMA levels were significantly higher in the patient group compared to control group (p=0,0001). Negative significant correlation was detected between IMA and total thiol/native thiol. There was no significant correlation between age, gender, HBV DNA, ALT, biopsy necrosis, fibrosis scores and native thiol, total thiol, disulfide, IMA levels in the patient group in pearson correlation analysis. Conclusions: Total thiols, native thiols and IMA levels were significantly lower in the patient group compared to the control group while no significance was detected in terms of disulphide levels. There was no correlation between viral load, liver necroinflammation and fibrosis grade and these values. Results from this study showed that antioxidant capacity decreases in patients with chronic hepatitis B but these markers are insufficient to determine the degrees of disease severity. Further studies with larger samples need to be carried out.