Chronic inflammation involves CCL11 and IL-13 to facilitate the development of liver cirrhosis and fibrosis in chronic hepatitis B virus infection.

Affiliation

Wong SW(1), Ting YW(1), Yong YK(1)(2), Tan HY(1)(3), Barathan M(4), Riazalhosseini B(5)(6), Bee CJ(7), Tee KK(4), Larsson M(8), Velu V(9)(10), Shankar EM(11), Mohamed R(12).
Author information:
(1)Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
(2)Laboratory Centre, Xiamen University Malaysia, Sepang, Malaysia.
(3)Department of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia.
(4)Faculty of Medicine, Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia.
(5)Faculty of Medicine, Department of Pharmacology, University of Malaya, Kuala Lumpur, Malaysia.
(6)Department of Microbiology, College of Basic Science, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran.
(7)School of Healthcare and Medical Sciences, Sunway University, Selangor, Malaysia.
(8)Division of Molecular Medicine and Virology, Department of Biomedicine and Clinical Sciences, Linköping University, Linköping, Sweden.
(9)Division of Microbiology and Immunology, Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
(10)Department of Pathology and Laboratory Medicine, Emory Vaccine Center, Emory University, Atlanta, GA, USA.
(11)Infection Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India.
(12)Gastroenterology Unit, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.

Abstract

The pathogenesis involving non-alcoholic fatty liver disease (NAFLD) in the context of chronic HBV (CHB) virus infection requires to be understood for developing improved modalities of diagnosis and treatment. We retrospectively investigated the association between NAFLD and CHB virus infection in the context of liver fibrosis. Among the 522 consecutive CHB patients who underwent transient elastography between years 2013 and 2016, we studied 455 subjects in the current investigation. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) scores were generally higher in patients with steatosis and fibrosis or cirrhosis. Antiviral treatment had significantly reduced the hepatitis B virus (HBV) viral load. Other liver function markers showed a significant positive correlation with both CAP and LSM scores. Plasma IL-13 was independently associated with increased CAP score where every increase of 1 unit of IL-13 was associated with an increase in CAP score by 0.98 unit. CCL11 was independently associated with LSM with every increase of CCL11 by a unit that, in turn, was associated with an increase of LSM score. We found that there was a high concurrence of NAFLD among patients with CHB virus infection. The presence of metabolic syndrome and chronic inflammation in CHB virus-infected patients were two independent factors that led to the progression of liver cirrhosis, with IL-13 playing the key role in linking the metabolic with the inflammatory components.