الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
According to World Health Organization, chronic infection with hepatitis C affects millions (130-150) of people globally and each year about 700 thousands of people die from its related liver diseases. Because it often remains undiagnosed until serious liver damage, CHC is the most common cause of liver disease (including liver fibrosis, cirrhosis and cancer) and the most common indication for liver transplantation in many areas of the world.
It is well known that genome guardian p53 suppressing tumor development in several organs. Other studies have revealed new p53 aspects like regulation of multiple biological functions such as autophagy, senescence, glycolysis and anti-oxidation indicating that this protein is involved even in the pathophysiology of several non-tumorous conditions. In light of the limited availability and high cost of many fibrosis markers our study was designed to evaluate the possibility of using p53 circulating protein as a serum biomarker of liver fibrosis in CHC patients. Serum samples from 158 CHC patients (109 males and 49 females) and 32 age-matched healthy individuals (21 males and 11females) were collected.Liver fibrosis was classified according to Metavir scoring. Among CHC patients there were 80/158 (50.6%) with fibrosis stage F1, 40/158 (25.3%) with fibrosis stage F2, 21/158 (13.3%) with fibrosis stage F3 and 17/158 (10.8%) with fibrosis stage F4.
Some of liver function tests (aspartate aminotransferase and alanine aminotransferase, alkaline phosphatase, albumin, bilirubin), platelets count and INR were measured for serum samples of both CHC patients and the controls using standard methods.from another view, p53 detection rate increase (P<0.05) with disease progression as it was 56.2% in mild fibrosis (F1), 72.1% in moderate-severe fibrosis (F2-F4) and 82.4% in cirrhosis (F4).
The mean p53 optical density level in CHC patients (0.49±0.17) was higher than in normal individuals (0.27±0.06) (P<0.0001). This level increase (P<0.02) in patients with significant fibrosis (F2-F4; 0.51±0.18) than in mild fibrosis (F1; 0.43±0.13) and in patients with advanced fibrosis (F3-F4; 0.58±0.22) than in non-advanced fibrosis (F1-F2; 0.44±0.13) (P<0.0001).
from another view, p53 mean optical density level was 0.27±0.06, 0.43±0.13, 0.48±0.15 and 0.62±0.26 in healthy, mild fibrosis (F1), moderate-severe fibrosis (F2-F3) and cirrhosis (F4), respectively.
In conclusion, circulating p53 protein was identified in serum samples of CHC patients by using western blot technique at 53 kDa. Using mono-specific p53 antibody as a probe in ELISA, in contrast to negative control individuals, elevated serum p53 levels were detected in CHC patients. Thus, detection of p53 as individual or in combination with other serum markers in liver diseases might be helpful in differential diagnosis between chronic hepatitis C patients with different fibrotic liver stages and those without.