Relation of cytokeratin 18-Apoptosense M30 to activity and fibrosis in chronic HCV patients

• Liver biopsy is the gold standard for assessment of liver diseases.
• Non-invasive methods for assessment of liver disease are warranted.
• CK-18 is an intermediary filament protein.
• Resultant CK-18 fragments can be detected in serum.
• Elevated serum CK18-M30, an indicator of hepatocyte death.

Hepatitis C virus (HCV) is a progressive disease that may result in Chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Cytokeratin(CK)18 is an intermediary filament protein, expressed in hepatocytes, which is proteolytically cleaved during liver damage. M30 epitope of cytokeratin18(CK18-M30) is involved at different levels in apoptotic pathways. The aim of this study to investigate the diagnostic accuracy of cytokeratin 18-apoptosin M30 fragments (CK18-M30) as non-invasive method of liver fibrosis assessment and their correlation to METAVIR score. Serum concentrations of CK18-M30 were measured by ELISA in One hundred and sixty eight chronic hepatitis C patients (112 males and 56 females). Results showed that serum concentrations of CK18 were significantly increased in a stepwise fashion from A0 to A3 and from F0 to F4.There was highly significant positive correlation between CK18 and fibrosis stages (r = 0.881 & p < 0.001) and activity grades (r = 0.881 & p < 0.001). Also, serum CK18 correlated positively with serum levels of transaminases (r = 0.355 & p < 0.05). CK18 was correlated positively with viral level (r = 0.3 & p < 0.05). It was concluded that Elevated serum CK18-M30, as an indicator of enhanced apoptosis of hepatocytes, was increased and correlated significantly with inflammation severity, stages of fibrosis, transaminases (ALT) levels and viral load in chronic HCV patients. These findings may place CK18-M30 as a non-invasive marker of liver fibrosis and disease activity.