IN-SITU DETECTION OF LIPID-PEROXIDATION IN CHRONIC HEPATITIS-C - CORRELATION WITH PATHOLOGICAL FEATURES

Aims - To assess the occurrence of lipid peroxidation in chronic hepat itis C and to evaluate its relation to pathological features and liver iron concentrations. Methods - Liver biopsy samples of 43 patients wi th untreated chronic hepatitis C were studied by immunohistochemistry using specific antibodies directed against two major aldehyde metaboli tes of lipid peroxidation, malondialdehyde (MDA), and 4-hydroxynonenal (HNE). Results - MDA and HNE adducts (aldehydes covalently Linked to another molecule) were detected in the liver samples in 77% and 30% of cases, respectively. MDA adducts were detected both in the extracellu lar matrix and sinusoidal cells localised in areas of periportal and l obular necrosis. HNE adducts appeared in the cytoplasm of only a few h epatocytes. Comparison of the semiquantitative assessment of adducts ( MDA and HNE indexes) with the grading and the staging of chronic hepat itis showed that the MDA index was correlated with fibrosis score (p < 0.001) and the grade of activity (p < 0.01). There was also a tendenc y to correlation with liver iron concentration (p = 0.09). No correlat ion was observed between the HNE index and pathological features or li ver iron concentration. Conclusion - Lipid peroxidation products are d etectable in the liver of chronic hepatitis C patients. The presence o f MDA adducts in areas of active fibrogenesis and the correlation betw een the MDA index and fibrosis score suggest a role for Lipid peroxida tion in liver fibrosis.