Otoimmün Hepatit Hastalarında Serum HLA-G Profilinin Tedavi Yanıtı ve Prognoz Üzerine Etkisi

Abstract

Taşgöz, FC. Effect of serum HLA-G profile on treatment response and prognosis in autoimmune hepatitis patients. Hacettepe University Faculty of Medicine, Thesis in Internal Medicine Department, Ankara, 2018. Aim: In this study, we aimed to determine the HLA-G profile level of plasma samples which was taken at the time of diagnosis of autoimmune hepatitis patients and to compare HLA-G molecule with patients who respond well to treatment, who did not response well to treatment and control group. Material and Method: Patients who were diagnosed with autoimmune hepatitis between 2010 and 2015 were included in the study. According to examination notes held every six months which obtained from patient files, the patients were divided into two groups one with good response to treatment and the other with poor response the treatment. We chose healthy adults who are similar ages with patients for control group. We determined plasma HLA-G molecule level using by ELISA (Enzime-Linked ImmunoAbsorbent Assay) method. The findings were recorded as ng/ml. Results: A total of 59 subjects including 29 patients and 30 controls were included in the study. Plasma samples and data of patients and control groups were analyzed. We compared plasma HLA-G molecule level of the patient and control groups we found that the molecule level was significantly higher in the patient group [ patient median: 62,6 ng/mL (14,7-231); control median: 34ng/mL (1,43-137); p=0,001]. The HLA-G molecule was found to be significantly higher in the patients who respond well to treatment when compared with 18 (30.5%) patients who respond well to treatment and 11 (18.6%) who did not not response well to treatment [good response to treatment: 71,1 ng/mL (16,6-231); poor response to treatment: 41,6ng/mL (14-131); p=0,001] . When we compared plasma HLA-G molecule level of patients who respond well to treatment with control subjects, we found that the molecule level was significantly higher in patient who respond well to treatment (p=0,004). We also compared plasma HLA-G levels of patients who did not response to treatment well with control group. We didn’t find any differences (p=0,750). When the relationship between HAI score and HLA-G molecule was evaluated, statistically significant, moderate, negative correlation was detected (p=0,005; rho= -0,519). We selected 52.5ng / ml as cut off value for indicating the HLA-G titre can predict whether the disease will respond well to treatment or not. Sensitivity was determined as 72.2 specificity was determined as 78 and the area under the curve was found to be 0.768. Conclusion: In our study, we found that HLA-G molecule levels in autoimmune hepatitis patients were higher than control group, and that high HLA-G levels were associated with good treatment response. We also found a negative correlation between HAI score and HLA-G level. These findings show that HLA-G molecule may be used for predicting response to treatment and prognosis of autoimmune hepatitis. And they also provide data for further studies.