Iron, hepatic stellate cells and fibrosis in chronic hepatitis C

BACKGROUND/AIMS

In patients with chronic hepatitis C, hepatic iron concentration correlates with liver fibrosis. However, it is not clear whether this correlation merely reflects the presence of more active disease, or iron exacerbates chronic hepatitis C virus (HCV)-induced damage through activation of hepatic stellate cells and regeneration of hepatocytes.

MATERIALS AND METHODS

We studied 72 HCV-positive patients, staged according to the Ishak's score system. We measured hepatic iron concentration with spectrophotometry and evaluated the number of hepatic stellate cells (using monoclonal antibody against alpha smooth muscle actin) and proliferating hepatocytes (using monoclonal antibody against Ki67). Iron and ferritin serum levels were also determined.

RESULTS

Hepatic iron concentration correlated statistically with ferritin serum level (r = 0.59, P < 0.001), with grading (r = 0.47, P < 0.001) and staging (r = 0.51, P < 0.001) scores for chronic hepatitis in the whole group of patients. Hepatic iron concentration correlated positively with stellate cell number (r = 0.55, P = 0.004) and Ki67-positive hepatocyte number (r = 0.36, P = 0.08) in patients with chronic hepatitis C and low grading score (< 3).

CONCLUSIONS

In patients with chronic hepatitis C and low grading score, hepatic iron could play a role in the activation of hepatic stellate cells and in the progression of fibrosis.

Chronic hepatitis C is mild in menstruating women

BACKGROUND AND AIMS

Women with chronic hepatitis C may have a slower rate of disease progression than men. We have previously demonstrated a relationship between hepatic iron concentration and liver fibrosis in patients with chronic hepatitis C. Our aim was to compare hepatic histologic findings, iron status and other factors putatively capable of determining the severity of chronic hepatitis between menstruating women and men of comparable age.

METHODS

We studied 21 consecutive hepatitis C virus (HCV)-RNA positive menstruating women and 24 consecutive HCV-RNA positive men of comparable age, who underwent liver biopsy for chronic hepatitis C. Alcohol intake was recorded and blood tests, HCV genotyping, serum iron, unsaturated iron binding capacity, serum ferritin, hepatic iron concentration, and liver histology were evaluated.

RESULTS

Menstruating women showed lower grading (2.7 +/- 1.5 vs 3.6 +/- 2, P = 0.09) and significantly lower staging (1.38 +/- 1.11 vs 2.42 +/- 1.64, P = 0.037) scores than men of comparable age. Among the factors putatively capable of determining the severity of chronic hepatitis, only the hepatic iron concentration correlated with the hepatic histologic staging in a multivariate analysis. Iron-depleted women (transferrin saturation < 20% and/or serum ferritin < 9 micrograms/L) showed significant lower hepatic histologic grading (1.75 +/- 0.7 vs 3.23 +/- 1.55, P = 0.027) and staging (0.75 +/- 1.03 vs 1.77 +/- 1.01, P = 0.026) scores than women with normal iron status.

CONCLUSIONS

Menstruating women with chronic hepatitis C may have a milder disease compared to men of comparable age, possibly because of menstrual blood loss and lower hepatic iron concentration. Women with chronic hepatitis C and iron deficiency have a milder disease compared to women with normal iron status, suggesting that iron deficiency results in a slower rate of disease progression.

Physiological, social, and behavioral consequences of crowding on children and adolescents

The present investigation was designed to examine systematically the effects of short-term crowding, involving close physical proximity, on children and adolescents. Fourth-, eighth-, and eleventh-grade children participated in groups of 4 under high or moderate spatial density conditions. During exposure to these conditions, physiological responses were measured, and following this experience children engaged in a cooperation-competition activity and provided self-reports related to their participation. Results demonstrated that crowding had physiological, behavioral and social consequences for the children studied. Across all grade levels, males in particular were more affected by short-term crowding, displaying the highest elevations in stress-related arousal. Following exposure to the crowding conditions, children were more competitive, despite the fact that they had all to gain from cooperating and nothing to lose. Furthermore, children reported having felt crowded, tense, annoyed, and uncomfortable as a function of the close physical proximity to others. Implications of the immediate and residual effects of crowding on the behavior and functioning of children are discussed.

[Myoepithelial-epithelial carcinoma of the parotid: cyto-histological description of a case]

We report a case of epithelial-myoepithelial carcinoma of the parotid gland arised in a 72 years-old woman, in which the diagnosis was suspected on fine-needle aspiration and confirmed on surgical specimen. Immunohistochemical evidence for the dual differentiation (glandular and myoepithelial) of the tumour was obtained both on surgical specimen and cytological inclusion. Morphological features and proliferating index (MIB1) analysis suggest that this case is an intermediate grade malignant neoplasm. Main differential diagnosis of the epithelial-myoepithelial carcinoma with predominantly clear cell tumours of the salivary glands were discussed.

Hormonal modulation of GM-CSF receptor alpha-chain in in vitro models of endometrial cancer

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine that stimulates the proliferation and differentiation of bone marrow progenitors. Moreover, the presence and activity of GM-CSF and its receptor (GM-CSF-r) has been documented on tissues and cell lines of a non-hemopoietic origin. In this paper we studied the expression and putative role of GM-CSF and GM-CSF-r in endometrial cancer. The modulation of GM-CSF-r alpha-chain upon progesterone treatment suggests a role for GM-CSF and its receptor in the pathogenesis and development of endometrial cancer.