1. Introduction and aim of the work
Liver is one of the most important organs of the human body which performs many body functions essential to maintain homeostasis in the organism. Disruption of the hepatic functions is commonly takes place due to viral hepatitis, parasitic infection and intoxication with hepatotoxinsCITATION Lef l 1033 (Lefkowitch, 2011).
Hepatitis C virus (HCV) infection is a substantial health problem worldwide and a serious cause of liver inflammation, cirrhosis, liver cancer and death. CITATION MAn11 l 1033 (Angelico, 2011) Globally, not only about 170 million individuals are chronically infected with the virus and are at risk of developing cirrhosis and hepatocellular carcinoma (HCC) but also a number exceeds 350.000 patients pass away annually because of the virus.CITATION Eve99 l 2057 (Shepard, Finelli, & Alter, 2005) CITATION Moh13 l 2057 (Mohd, Groeger, Flaxman, & Wiersma, 2013).
CITATION Ban11 l 2057 (Bansal & Friedman, 2011) defined liver fibrogenesis as the natural dynamic wound healing response to a hepatic injury resulting from a chronic non-resolved inflammation accompanied with excessive deposition of extracellular matrix (ECM) proteins including collagen to form a scar tissue in order to encapsulate the damaged area. Progressive liver fibrosis results in cirrhosis, liver failure, and portal hypertension and often requires liver transplantation (Friedman, S.L. 2003).
Evaluation of the degree of hepatic fibrosis (i.e. staging) is essential for several reasons: (1) to determine the prognosis of the chronic liver disease, (2) to select patients for specific anti-fibrotic treatment strategy, and (3) for monitoring the success of the treatment process. Liver biopsy specimens represent the most valuable material for the staging of hepatic fibrosis as well as the degree of necroinflammation. Despite that, it has some technical limitations related to sampling and interpretation with a significant risk. For this reason, there was an urgent need to develop simple and reliable noninvasive biomarkers to detect the progress of disease instead.
Tenascins symbolize one of the groups of ECM glycoproteins in vertebrates including four family members: tenascin-C, tenascin-X, tenascin-R, and tenascin-W,CITATION Chi04 l 2057 (Chiquet-Ehrismann & Tucker, 2011). Tenascin-C (TN-C) is a large hexameric glycoprotein that is potentially expressed during embryonic development as well as tissue remodeling and in pathological conditions, tumorigenesis, and metastasis in adults. Previous studies strongly suggested that there is a correlation between TN-C expression and liver fibrogenesis. It was reported that TN-C induces inflammatory response at the site of infection accompanied with cytokine up-regulation, enhances hepatic stellate cells (HSCs) accumulation, and induces transforming growth factor-? (TGF-?) expression. CITATION ElK071 l 2057 (El-Karef, et al., 2007)Aim of the Work
The aim of the present study is to evaluate TN-C and TGF-? levels in sera of HCV patients using enzyme-linked immunosorbent assay (ELISA).Their correlation with the severity of the disease will be discussed and the possible involvement of oxidative stress in their action will be investigated in order to evaluate TN-C whether it can be used as a reliable marker in assessing the prognosis of the disease or not.