In the present study, liver function tests were

In the present study, liver function tests were significantly elevated whereas log-HCV titer was significantly lower in HCC patients (p < 0.001) when compared to PNALT and CLD patients. In agreement with our findings, HCC group had learn more the highest values (86.3%) for various concurrently-measured liver function tests, significant higher values of AST/ALT, ALT, AST (each, p < 0.001) than cirrhotic patients as previously reported [40]. On the other hand, HCV levels were markedly higher in non-cancerous liver than in HCC (p = 0.001) [41]. Moreover, comparing HCV titers of four HCC isolates and surrounding cirrhotic liver tissues in two anti-HCV

positive patients; the copy numbers of HCV-RNA were 1 × 106 and 4 × 106/gm wet weight of HCC, and 8 × 107 and 3.2 × 108/gm wet weight of cirrhotic liver tissues from patient-1 and -2, respectively [42]. The present study showed that men had higher log-HCV RNA titer than that detected in women; then, a strong

evidence is provided in favour of a higher HCV clearance rate in women compared with that in men [43]. Fas (APO-1 or CD95) is a cell-surface receptor that transduces apoptotic signals from Fas ligand (Fas-L) [44]. Apoptosis is tightly regulated throughout a variety of mechanisms, one of which is postulated to be the production of soluble forms of Fas (sFas) that normally HDAC inhibitor binds to Fas-L, thus blocking the signaling of the membrane-bound form Etomidate of Fas. Peripheral blood mononuclear cells in HCV infection exhibit decreased susceptibility to Fas-L induced cell death. This may signify a mean by which HCV escapes immune surveillance; however, it would be worth a further investigation on this phenomenon. The sFas appeared to increase in advanced stages of HCV-induced liver disease, as a result of host-related immunological factors [45]. In the present series, the mean values of sFas were significantly higher in HCC patients compared to the other groups (p < 0.001). This could be explained by the role of sFas in the inhibition of apoptosis, progression to end stage liver damage, and subsequent development of HCC. Similarly, a significant

elevation of serum levels of sFas in HCC patients compared with liver cirrhosis and healthy control was previously reported [46]. Previous studies [47, 48] have reported mRNA encoding secreted sFas in a number of hepatitis and HCC cases indicating that sFas may function as an inhibitor of the Fas/Fas-L system and escape of tumor cells from immune surveillance may then occur. In chronic hepatitis, sFas was correlated with the severity of disease [15] and its expression can illustrate the mechanism of liver injury caused by death receptors throughout the multistep process of fibrosis/carcinogenesis. So, the increased incidence of HCC is correlated not only with the higher degree of hepatic DMXAA fibrosis, but also with the lower expression of Fas protein [49].

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