Summary
- An elevated serum αGST indicates active disease.
- αGST falls before transaminases if treatment is successful.
- αGST rises earlier than transaminases in relapse.
- αGST complements HCV RNA measurents by providing an indication of active hepatic inflammation.
- “Cure” requires the normalisation of both αGST and transaminases.
- Serum collagen IV is an indicator of the extent of hepatic fibrosis.
- An elevated serum collagen IV indicates a probable poor response to therapy.
- Successful therapy is associated with a decline in collagen IV.
Alpha GST Articles
1) Utility of alpha-glutathione S-transferase assessment in chronic hepatitis C patients with near normal alanine aminotransferase levels.
Giannini, E., Risso, D., Ceppa, P., Botta, F., Chiarbonello, B., Fasoli, A., Malfatti, F., Romagnoli, P., Lantieri, P.B. and Testa, R. (2000). Clin. Biochem. 33(4) 297-301.
- 119 Subjects with “normal” ALT but elevated αGST had 60 times higher blood HCV-RNA concentrations
2) The role of α-glutathione S-transferase in the monitoring of hemodialysis patients with hepatitis C virus infection undergoing high-dose Interferon-α-2b therapy.
Boran, M. and Cetin, S. (1999). Nephron 82(1) 222-6.
- αGST remained high in all those who remained HCV-RNA positive, even if ALT normalised.
- αGST fell sooner than ALT in responders.
3) Alpha-glutathione transferases in HCV related chronic hepatitis: a new predictive index of response to interferon therapy?
Loguercio, C., Caporaso, N., Tuccillo, C., Morisco, F., Del Vecchio Blanco, G. and Del Vecchio Blanco, C. (1998). Journal of Hepatology 28 390-395.
- Failure of αGST to fall indicated treatment failure
- A sustained response to interferon required normalisation of both αGST and ALT
- αGST indicated relapse much sooner than ALT. In patients who relapsed:
- αGST levels started to rise after 2 months.
- ALT did not rise until after 12 months when Interferon therapy was terminated.
Collagen IV Articles
1) Serum collagen IV for the assessment of fibrosis and resistance to Interferon therapy in chronic hepatitis.
Yabu, K., Kiyosawa, K., Mori, H., Matsumoto, A., Yoshizawa, K., Tanaka, E. and Furuta, S. (1994). Scand. J. Gastroenterol. 29(5) 474-9.
- Elevated serum collagen IV levels predicted resistance to therapy.
- Serum collagen IV levels fell during successful therapy.
2) Increased amount of serum type IV collagen peptide in human liver fibrosis as determined by enzyme-immunoassay with monoclonal antibodies.
Matsumoto, E., Muragakim Y. and Ooshima, A, (1989). Acta. Pathol. Japan 39 217223.
- Serum levels of collagen IV correlated with the extent of hepatic fibrosis.
