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DOI: https://doi.org/10.22263/2312-4156.2019.4.46

Pryshchepenka V.A.
Blood serum enzymatic activities for the diagnosis and differential diagnosis of chronic diffuse liver diseases
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2019;18(4):46-59.

Abstract.
Differential diagnosis of chronic hepatitis and hepatic cirrhosis in the early stages without the use of liver biopsy is difficult, and therefore the search for noninvasive markers of chronic diffuse liver diseases remains relevant. Changes in the enzymatic activities of blood serum can be used in the development of noninvasive markers of liver fibrosis and cirrhosis.
Objectives. To evaluate the possibility of using blood serum enzymatic activities as non-invasive markers of liver fibrosis and cirrhosis.
A total of 41 patients with chronic hepatitis and 102 patients with hepatic cirrhosis were examined. The control group included 43 practically healthy people. Patients underwent clinical and laboratory examinations, liver cirrhosis indices, levels of interleukin-13, alpha-1-defensin, hyaluronidase, trypsin-like, deoxyribonuclease and elastase blood serum levels were determined. In patients with chronic hepatitis, an increase in serum hyaluronidase, trypsin-like, deoxyribonuclease and elastase activity was found in comparison with the control group (p<0.05). In patients with liver cirrhosis, there was an increase in hyaluronidase, deoxyribonuclease and elastase, as well as a decrease in the trypsin-like activity of blood serum compared with healthy individuals (p<0.05). The correlations of the studied activities with clinical and laboratory parameters, the levels of interleukin-13 and alpha-1-defensin were established. The cut-off values of the activities were determined, at which, with high sensitivity and specificity, they can be used for the diagnosis and differential diagnosis of chronic diffuse liver diseases.
Key words: chronic hepatitis, liver cirrhosis, hyaluronidase activity, trypsin-like activity, deoxyribonuclease activity, elastase activity.

The study was supported by the Belarusian Republican Foundation for Fundamental Research.

References

1. M-vo zdravookhraneniia Resp Belarus'. Diagnosis and treatment of patients with digestive diseases: klinicheskii protokol: postanovlenie M-va zdravookhraneniia Resp Belarus' 21 avg 2016 g № 90. Gepatologiia i gastroenterologiia. 2017;1(1):99-117. (In Russ.)
2. Lin ZH, Xin YN, Dong QJ, Wang Q, Jiang XJ, Zhan SH, et al. Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology. 2011 Mar;53(3):726-36. doi: http://dx.doi.org/10.1002/hep.24105
3. Güzelbulut F, Çetınkaya ZA, Sezıklı M, Yaşar B, Ozkara S, Övünç AO. AST-platelet ratio index, Forns index and FIB-4 in the prediction of significant fibrosis and cirrhosis in patients with chronic hepatitis C. Turk J Gastroenterol. 2011 Jun;22(3):279-85. F. doi: http://dx.doi.org/10.4318/tjg.2011.0213
4. Paczek L, Michalska W, Bartlomiejczyk I. Trypsin, elastase, plasmin and MMP-9 activity in the serum during the human ageing process. Age Ageing. 2008 May;37(3):318-23. doi: http://dx.doi.org/10.1093/ageing/afn039
5. Leroy V, Monier F, Bottari S, Trocme C  Sturm N, Hilleret MN, et al. Circulating matrix metalloproteinases 1, 2, 9 and their inhibitors TIMP-1 and TIMP-2 as serum markers of liver fibrosis in patients with chronic hepatitis C: comparison with PIIINP and hyaluronic acid. Am J Gastroenterol. 2004 Feb;99(2):271-9.
6. Generalov II, Litvyakov AM, Kunder EV, Moiseeva AM; M-vo zdravookhraneniia Resp Belarus', Vitebskii gos ordena Druzhby narodov med un-t. Determination of the enzymatic (hyaluronidase and deoxyribonuclease) activity of depolymerizing action in autoimmune and infectious pathologies: instruktsiia po primeneniiu. Vitebsk, RB; 2007. 11 р. (In Russ.)
7. Okulich VK, Kosinets AN, Sen'kovich SA, Konopel'ko EA. Determination of DAPNA amidase activity of microorganisms, blood serum and class G immunoglobulins [Elektronnyi resurs]: instruktsiia po primeneniiu № 6-0101, utv M-vom zdravookhraneniia Resp Belarus'17 maia 2002 g. V: Sovremennye metody okazaniia meditsinskoi pomoshchi (diagnostiki, lecheniia i meditsinskoi profilaktiki zabolevanii, meditsinskoi reabilitatsii patsientov, protezirovaniia): nauch polnotekstovaia baza dannykh. Minsk, RB; 2019. Rezhim dostupa: http://med.by/methods/book.php?book=261. Data dostupa: 19.08.2019. (In Russ.)
8. Okulich VK, Kornilov AV, Savkina YuG, Sen’kovich SA. Determination of elastase activity in biological fluids. V: Dostizheniia fundamental’noi, klinicheskoi meditsiny i farmatsii: materialy 67-i nauch ses sotr un-ta, Vitebsk 2–3 fevr 2012 g. Vitebsk, RB; 2012. Р. 100-1. (In Russ.)
9. Yupatov GI, Okulich VK, Sen'kovich SA, Prishchepenko VA. Method for determining the activity of serum deoxyribonucleases: instruktsiia po primeneniiu № 002-0119, utv M-vom zdravookhraneniia Resp Belarus' 6 marta 2019 g. Vitebsk, RB; 2019. 8 р. (In Russ.)

Information about authors:
Pryshchepenka V.A. – postgraduate of the Chair of Internal Diseases Propedeutics, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of of Internal Diseases Propedeutics. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Viachaslau A. Pryshchepenka.

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