Background: Interleukin-4 (IL-4) is an important modulator in the immune response of
macrophages, B and T cells to stand in front of infections and malignancy. Objectives:
This study aimed to assess the association between IL-4 gene 590CT polymorphism and
risk of hepatocellular carcinoma (HCC) on top of viral hepatitis. Methodology: This
study was conducted on 220 patients and 60 apparently healthy individuals. One
hundred and twenty patients with HCV infection (group 1) classified as sixty patients
with liver cirrhosis and sixty with HCC, one hundred patients with HBV infection (group
2) classified as fifty with liver cirrhosis and fifty with HCC. Virus status of the patients
was confirmed by measuring HBsAg, HCV antibodies and real time PCR. Liver cirrhosis
was assessed by laboratory investigations, abdomino-pelvic ultrasound and CHILD
score. Patients with HCC were diagnosed by triphasic CT, alphafeto-protein level (AFP)
and biopsy. The studied groups were genotyped for IL-4 590C/T gene polymorphisms by
polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)
method. Results: IL-4 590C/T gene analysis detected significant variation between
studied groups, regarding genotype and allele frequencies (p=0.025 and p=0.002
respectively). There were higher frequencies of CC genotype and C allele in HCC and
cirrhotic hepatitis C patients than controls. C allele had higher prevalence in HCC than
cirrhosis in HBV patients. CT+CC genotype carriers had an elevated HCC risk odd
ratio (OR): 4.6 [95% CI: 1.5 –14] and OR 3.6 [95% CI: 1.1 –11.6], in HCV and HBV
patients in contrast to controls. C allele was associated with increased cirrhotic and
HCC risk in HCV infected patients with OR= 4 [95% CI: 1.8 – 8.8] and OR= 2.3 [95%
CI: 1.1 – 5.2] versus control group. In HBV patients C allele showed higher HCC risk
with OR= 4.2 [95% CI: 1.8 – 9.5] when compared to controls. Conclusion: IL-4 590C/T
gene polymorphism may have a role in occurrence of HCC on top of liver cirrhosis. |