Hepatic Expression of Nitric Oxide Isoforms and Serum Nitrites/Nitrates in Chronic Hepatitis C With or Without Schistosomiasis

  • Afkar Abdel-GhanyBadawy
  • Olfat Hammam
  • Mona Moussa
  • Raafat Atta
  • Tarek Aboshousha
  • Noha Said
  • Nihal El-Assaly
  • Nawal El-Badrawy
Keywords: Inducible nitric oxide synthase, Endothelial nitric oxide synthase, Chronic hepatitis C, Schistosomiasis, Immunohistochemistry.


Background: Role of nitric oxide (NO) in pathogenesis of chronic viral hepatitis is not fully understood but it seemsthat its overproduction is responsible for the pathological changes under inflammatory conditions.Methods: This study was undertaken to evaluate hepatic expression of inducible NO synthase (iNOS) and endothelial NO synthase (eNOS) as well as assessment ofserum nitrates/nitrites representative to NO releasein Egyptian chronic hepatitis C (CHC) with or without schistosomiasis and their relation to histopathologyin 72 core liver biopsies from CHC patients. Hepatic sections were immunohistochemically stained by antibodies of iNOS and eNOS.Results: In control livers, iNOS was detected in hepatocytes and localized mainly inperiportal zone of liver acinus, while eNOS was uniformly distributed in hepatocytes as well as in sinusoidaland vascular endothelium. In diseased livers, both isoformsoverexpressed in a diffuse distribution pattern, eNOS translocated to hepatocytic nuclei, and iNOS consistently labeled portal tract inflammatory cells. Over expression of iNOS and serum level of NO correlated with hepatitis activity and fibrosis, while that of eNOS correlated with Schistosomal coinfection.Conclusions: Chronic hepatitis C is accompanied by significant iNOS up-regulated expression and increased serum level of NO that reflect disease severity. Schistosomal coinfection can be considered as a risk factor for haemodynamic disturbance. Further studies are required to determine whether iNOS inhibitors could be useful in reducing liver disease severity and improve the benefits of antiviral therapies. 


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Original Article