Antineutrophil cytoplasmic antibody frequency in chronic hepatitis B patients.

BACKGROUND: Chronic hepatitis B (CHB) is a viral disease, common across the world, and associated with several extraintestinal manifestations including vasculitis. Antineutrophil cytoplasmic antibodies (ANCAs) are sensitive and specific markers for vasculitides. There is limited data available in the literature on whether ANCA formation is stimulated by CHB infection. In the present study we aimed to identify the frequency of ANCA in CHB patients. METHODS: A total of 174 subjects were included in the study (87 CHB patients, 87 control subjects). Perinuclear-ANCA (P-ANCA), cytoplasmic-ANCA (C-ANCA), myeloperoxidase ANCA (MPO-ANCA), and proteinase 3-ANCA (PR3-ANCA) were studied. IFA was used for P-ANCA and C-ANCA assays, and ELISA was used for MPO-ANCA and PR3-ANCA assays. RESULTS: ANCA positivity was high in both groups (31% in the CHB group and 26% among controls). There were no significant differences between the groups for P-ANCA and MPO-ANCA (P = 0.6 and P = 0.6, resp.). Frequency of borderline positive C-ANCA and all positive PR3-ANCA (positive + borderline positive) was significantly higher in the CHB group (P = 0.009 and P = 0.005, resp.). CONCLUSIONS: In the present study, the frequency of ANCA was high in both groups. The CHB group had a relatively higher frequency of ANCA positivity compared to controls. Borderline positive C-ANCA and positive PR3-ANCA were significantly higher in the CHB group. These results suggest that ANCA may have a high prevalence in Turkey. Patients with CHB should be evaluated particularly for C-ANCA and PR3-ANCA in the presence of vasculitic complaints and lesions.

Serum anti-Müllerian hormone levels are lower in reproductive-age women with Crohn's disease compared to healthy control women.

BACKGROUND AND AIM: Crohn's disease (CD) decreases fertility both directly, by inducing inflammation in the fallopian tubes and ovaries, and indirectly, through the surgical interventions and tubal adhesions associated with disease treatment. Anti-müllerian hormone (AMH) is a reliable indicator of ovarian reserve in women. We aimed to compare serum AMH levels between reproductive-age women with CD and healthy controls. METHODS: Serum AMH levels were measured by ELISA in 35 women with CD and 35 age-matched healthy women controls. RESULTS: CD patients and controls were similar in terms of age, height, weight and BMI. Mean CD duration was 60 months. CRP, ESR and leukocyte counts were significantly higher in CD patients compared to the controls (p<0.001, p=0.004 and p=0.04, respectively). AMH levels in CD patients (1.02 ± 0.72) were significantly lower compared to the controls (1.89 ± 1.80) (p = 0.009). Serum AMH levels in CD patients with active disease (0.33 ± 0.25) were significantly lower compared to CD patients who were in remission (1.53 ± 0.49) (p = 0.001). Serum AMH levels were similar in CD patients with a disease duration of less than 5 years (17 patients) and CD patients with a disease duration of greater than 5 years (18 patients) (p = 0.8). In CD patients, a negative correlation between CDAI and serum AMH levels was found (r = -0.718, p < 0.001). Serum AMH levels were similar in CD patients who had (6 patients) and had not undergone (29 patients) surgical treatment (p = 0.2). CONCLUSION: Serum AMH levels of reproductive-age women with CD were significantly lower compared to the controls. CDAI and AMH are inversely correlated.

Patients with inflammatory bowel disease have a lower response rate to HBV vaccination compared to controls.

BACKGROUND: Hepatitis B (HBV) is a vaccine-preventable infection that may cause severe infections, particularly in patients who are being treated with immunosuppressive therapy [(i.e., inflammatory bowel disease (IBD)]. Limited data are available about IBD patients' response rate to HBV vaccine. AIM: To assess the efficacy of HBV vaccine in IBD patients and healthy controls. METHODS: Serological markers of HBV were assessed in IBD patients, and HBV vaccine was administered to seronegative patients. The subsequent determination of anti-HBs antibody was recorded. An adequate immune response (AIR) and an effective immune response (EIR) to HBV were defined as more than 10 and 100 mIU/ml, respectively. The single dose vaccine was administered at 0, 1 and 6 months. RESULTS: A total of 102 patients with IBD (39 Crohn's disease, 63 ulcerative colitis; 54 female, 48 male) and 52 (25 female, 27 male) healthy controls were included. Mean age for patients and controls were 38 ± 12 and 31 ± 8, respectively (P < 0.001). Both AIR and EIR were significantly lower in patients than in controls (P < 0.001), but they were similar between patients with CD and UC (P = 0.302). Forty-four (43%) patients were on immunosuppressive therapy before vaccination. After vaccination, 76 and 53% of the patients had AIRs and EIRs, respectively, whereas 100 and 87% of the controls had AIRs and EIRs, respectively (P < 0.001 and P < 0.001, respectively). CONCLUSIONS: The response rate of IBD patients receiving HBV vaccinations were significantly lower compared to controls. The response rate of those receiving immunosuppressive therapy and with active disease was much too low. Vaccination should be given during remission and at immunosuppression-free times.

Serum levels of hepcidin in patients with biopsy-proven nonalcoholic fatty liver disease.

BACKGROUND: Research suggests the presence of mild-to-moderate iron overload in patients with nonalcoholic fatty liver disease (NAFLD). The role played by hepcidin, the master regulatory hormone of systemic iron metabolism, in the pathogenesis of NAFLD remains controversial. The aims of this study were to: (1) Evaluate serum hepcidin levels in patients with biopsy-proven NAFLD and age- and sex-matched controls and (2) identify the potential associations of hepcidin with the clinical and biochemical characteristics of the study participants. METHODS: Serum levels of hepcidin were measured by enzyme-linked immunosorbent assay and compared in 88 patients with NAFLD (56 males and 32 females; mean age, 44 ± 11 years) and 88 controls (51 males and 37 females; mean age, 43 ± 12 years). Moreover, concentrations of hepcidin were assessed in relation to the general characteristics of the study participants and the results of liver biopsy. RESULTS: Serum levels of hepcidin were significantly higher in patients with NAFLD (63.5 ± 19.5 ng/mL, P<0.001) compared with controls (32.7 ± 8.3 ng/mL). Multivariable regression analyses in patients with NAFLD showed that hepcidin levels were positively associated with total cholesterol (ß=6.9, t=3.3, P<0.01) and triglycerides (ß=1.4, t=2.4, P<0.05), but not with iron parameters, histological staging, and pathological characteristics of NAFLD. CONCLUSIONS: Although subject to future confirmation, our data suggest that hepcidin levels are elevated in NAFLD and could be associated with lipid parameters in this setting.