Case Control Study
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World J Gastroenterol. Sep 7, 2014; 20(33): 11793-11799
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11793
Molecular detection of monocyte chemotactic protein-1 polymorphism in spontaneous bacterial peritonitis patients
Maysa Kamal Salama, Dina Sabry, Mohamed AS Al-Ghussein, Rasha Ahmed, Sayed AbdAllah, Fatma Mohamed Taha, Wael Fathy, Miriam Safwat Wadie, Mona Nabih, Amr Abul-Fotouh, Tarneem Darwish
Maysa Kamal Salama, Dina Sabry, Fatma Mohamed Taha, Miriam Safwat Wadie, Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Cairo11562, Egypt
Mohamed AS Al-Ghussein, Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Gaza 1277, Palestine
Rasha Ahmed, Amr Abul-Fotouh, Tropical Medicine Department, Faculty of Medicine, Cairo University, Cairo11562, Egypt
Sayed AbdAllah, Mona Nabih, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
Wael Fathy, Tropical Medicine Department, Faculty of Medicine, Bny Swif University, Bny Swif 62511, Egypt
Tarneem Darwish, Biomedical Informatics and Biostatistics Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
Author contributions: Salama MK participated in the design of the study, drafted the article and revised it critically for important intellectual content; Sabry D carried out PCR and RNA extraction and real-time PCR and participated in manuscript writing and submissions; Al-Ghussein MAS participated in biotechnology procedures and carried out manuscript writing and submissions as a corresponding author; Ahmed R participated in the design of the study, revised and edited the manuscript critically for important intellectual content; AbdAllah S carried out the collection and monitoring of patient and control samples; Taha FM carried out the MCP-1 and IL-10 detection and manuscript writing; Fathy W provided the study materials, technical and logistic support and carried out hospital procedures; Wadie MS carried out the sample preparation, detection and provided vital reagents; Nabih M participated in clinical assessment of the patients; Abul-Fotouh A carried out manuscript revision; Darwish T carried out the statistical calculations; and all authors read and approved the final manuscript.
Correspondence to: Mohamed AS Al-Ghussein, PhD, Lecturer of Biochemistry and Medical Biochemistry, Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Talatini st., Gaza strip, Gaza 1277, Palestine. mohamedghussein@yahoo.com
Telephone: +972-2-01202717604 Fax: +972-2-0223658095
Received: October 28, 2013
Revised: May 5, 2014
Accepted: May 26, 2014
Published online: September 7, 2014
Abstract

AIM: To investigate the association of the functional monocyte chemotactic protein-1 (MCP-1) promoter polymorphism (A-2518G) with spontaneous bacterial peritonitis (SBP).

METHODS: Fifty patients with post-hepatitis C liver cirrhosis and ascites were categorized into two groups; group I included 25 patients with SBP and group II included 25 patients free from SBP. In addition, a group of 20 healthy volunteers were included. We assessed the MCP-1 gene polymorphism and gene expression as well as interleukin (IL)-10 levels in both blood and ascitic fluid.

RESULTS: A significant MCP-1 gene polymorphism was detected in groups I and II (P = 0.001 and 0.02 respectively). Group I was associated with a significantly higher frequency of AG genotype [control 8 (40%) vs SBP 19 (76.0%), P < 0.001], and group II was associated with a significantly higher frequency of GG genotype when compared to healthy volunteers [control 1 (5%) vs cirrhotic 16 (64%), P < 0.001]. Accordingly, the frequency of G allele was significantly higher in both groups (I and II) [control 10 (25%) vs SBP 27 (54%), P < 0.001 and vs cirrhotic 37 (74.0%), P < 0.001, respectively]. The total blood and ascetic fluid levels of IL-10 and MCP-1 gene expression were significantly higher in group I than in group II. Group I showed significant reductions in the levels of MCP-1 gene expression and IL-10 in the whole blood and ascetic fluid after therapy.

CONCLUSION: MCP-1 GG genotype and G allele may predispose HCV infected patients to a more progressive disease course, while AG genotype may increase the susceptibility to SBP. Patients carrying these genotypes should be under supervision to prevent or restrict further complications.

Keywords: Monocyte chemotactic protein-1, Genotype, Spontaneous bacterial peritonitis, Liver cirrhosis, Ascites, Gene expression, Interleukin-10

Core tip: Monocyte chemotactic protein-1 (MCP-1) polymorphism was investigated in hepatitis C virus (HCV) infected patients because of the higher susceptibility of cirrhosis and ascites patients to bacterial infections. MCP-1 secretion is up-regulated during chronic hepatitis and correlates with the severity of hepatic inflammation. Inheritance of MCP-1 GG genotype and MCP-1 G allele may predispose HCV infected patients to a more progressive disease course, while AG genotype may be a risk factor for spontaneous bacterial peritonitis (SBP) in patients with decompensated post-hepatitis C cirrhosis. MCP-1 expression and elevated IL-10 levels may be related to the development of SBP. HCV cirrhotic and SBP patients carrying the above genotypes should be under supervision and monitoring.