Increased ascites natural killer cells in patients with chronic hepatitis B cirrhosis using lamivudine: A pilot study

Year 2019, Volume: 18 Issue: 3, 80 - 86, 25.12.2019

İbrahim Köker Belkıs Ünsal

https://doi.org/10.17941/agd.676970

Abstract

Background and Aims: Natural killer cells play a direct role in liver injury and fibrogenic response. Peripheral blood natural killer cells have been studied widely in chronic liver diseases. We aimed to evaluate the ascites natural killer cell frequency and its significance in chronic hepatitis B related cirrhosis. Materials and Methods: Overall, 30 patients [23 males] with decompensated chronic hepatitis B cirrhosis with ascites were included. Patients with a recent ascites infection history and other etiologic factors besides chronic hepatitis B infection were excluded. After defining the demographic characteristics of the cases, we divided patients according to their Child-Turcotte-Pugh classification scores into two groups, and their natural killer (CD3−/CD16+/CD56+) cell frequencies in peripheral blood and ascites were studied using flow cytometry. Finally, we compared the natural killer cell frequencies in peripheral blood and ascites between the Child-Turcotte-Pugh classification groups based on lamivudine use. Results: Median lamivudine usage duration was 60 months, interquartile range 18.7–93 months in Child-Turcotte-Pugh B and 7.5 months, interquartile range 2.2–21 months in Child-Turcotte-Pugh C (p = 0.053). Ascites natural killer cells were significantly increased in lamivudine users of Child-Turcotte-Pugh B (p = 0.049), whereas no change was observed in peripheral blood - natural killer frequency in patients using lamivudine in the Child-Turcotte-Pugh B and C groups (p = 0.574 and p = 0.174, respectively). Conclusion: Long-term lamivudine use might have increased the ascites natural killer frequency, whereas no change was observed in the peripheral blood - natural killer cell frequency in patients with chronic hepatitis B cirrhosis, suggesting a potential role of antivirals in ascites natural killer cell response.

Keywords

Chronic hepatitis B, cirrhosis, ascites, natural killer cells

Kronik hepatit B’ye bağlı sirozda lamivudin kullanımı ile artan asit natural killer hücreleri: Pilot çalışma

Abstract

Giriş ve Amaç: Natural killer hücreler karaciğer hasarı ve fibrojenik cevapta doğrudan rol alırlar. Kronik karaciğer hastalıklarında periferik kanda natural killer hücreleri bir çok çalışmada araştırılmıştır. Amacımız asit natural killer sıklığını ve bunun kronik hepatit B’ye bağlı sirozdaki önemini araştırmaktı. Gereç ve Yöntem: Otuz erişkin (23 erkek) ardışık asitle dekompanse kronik hepatit B sirotik hasta çalışmaya alındı. Son zamanlarda asit infeksiyon öyküsü olanlar ve kronik hepatit B etiyolojisi dışında etiyolojik faktörü bulunan hastalar çalışmaya alınmadı. Olguların demografik özellikleri tanımlandıktan sonra Child-Turcotte-Pugh puanlarına göre iki gruba ayrıldılar. Bu olguların asit ve kan örneklerinde akım sitometrisi ile natural killer hücre sıklıkları araştırıldı. Daha sonra Child-Turcotte-Pugh B ve C grupları içinde lamivudine kullanımına göre natural killer hücre sıklıklarını karşılaştırdık. Bulgular: Lamivudin kullanım medyan süresi Child-Turcotte-Pugh B’de 60 ay, çeyrekler arası açıklık (18.7-93), Child-Turcotte-Pugh C’de 7.5 ay, çeyrekler arası açıklık (2.2-21) idi (p=0.053). Asit natural killer hücreleri Child-Turcotte-Pugh B grubunda lamivudin kullananlarda, kullanmayanlara göre belirgin olarak artarken (p=0.049), periferik kan natural killer hücrelerinde her iki grup arasında farklılık saptamadık (sırasıyla p=0.574 ve p=0.174). Sonuç: Uzun dönem lamivudin kullanımı kronik hepatit B’ye bağlı sirozda periferik kan natural killer hücre sıklığında değişiklik oluşturmamakta iken, asitte natural killer hücre sıklığını arttırmış olabilir. Bu durum asit natural killer hücrelerinin antivirallere cevapta potansiyel rollerinin olduğunu düşündürmektedir.

Keywords

Kronik hepatit B, siroz, asit, natural killer hücreleri, lamivudin

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