Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype

Takashi Motomura, Ken Shirabe, Norihiro Furusyo, Tomoharu Yoshizumi, Toru Ikegami, Yuji Soejima, Tomohiko Akahoshi, Morimasa Tomikawa, Takasuke Fukuhara, Jun Hayashi, Yoshihiko Maehara

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV) therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined.Methods: Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group) and 90 who did not (non-Spx group) were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15) and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen.Results: Sustained virological response (SVR) rate was higher in patients carrying IL28B major genotype following splenectomy (50% vs 27.3%) and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3% vs 3.6%, P < 0.05). Pretreatment splenic ISG expression was higher in patients carrying IL28B major. There was no difference in progression of anemia or thrombocytopenia between patients carrying each ITPA genotype in the Spx group. Although splenectomy did not increase hemoglobin (Hb) level, Hb decline tended to be greater in the non-Spx group. In contrast, splenectomy significantly increased platelet count (61.1 × 103/μl vs 168.7 × 103/μl, P < 0.01), which was maintained during the course of PEG-IFN/RBV therapy.Conclusions: IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.

Original languageEnglish
Article number158
JournalBMC Gastroenterology
Volume12
DOIs
Publication statusPublished - Nov 12 2012

Fingerprint

Splenectomy
Hepatitis C
Fibrosis
Genotype
Interferons
Ribavirin
Thrombocytopenia
Anemia
Hemoglobins
Spleen
Platelet Count
Protein Kinases
Therapeutics
RNA
Proteins

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype. / Motomura, Takashi; Shirabe, Ken; Furusyo, Norihiro; Yoshizumi, Tomoharu; Ikegami, Toru; Soejima, Yuji; Akahoshi, Tomohiko; Tomikawa, Morimasa; Fukuhara, Takasuke; Hayashi, Jun; Maehara, Yoshihiko.

In: BMC Gastroenterology, Vol. 12, 158, 12.11.2012.

Research output: Contribution to journalArticle

Motomura, Takashi ; Shirabe, Ken ; Furusyo, Norihiro ; Yoshizumi, Tomoharu ; Ikegami, Toru ; Soejima, Yuji ; Akahoshi, Tomohiko ; Tomikawa, Morimasa ; Fukuhara, Takasuke ; Hayashi, Jun ; Maehara, Yoshihiko. / Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype. In: BMC Gastroenterology. 2012 ; Vol. 12.
@article{185eef4598514a9cab584d681cb35218,
title = "Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype",
abstract = "Background: IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV) therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined.Methods: Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group) and 90 who did not (non-Spx group) were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15) and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen.Results: Sustained virological response (SVR) rate was higher in patients carrying IL28B major genotype following splenectomy (50{\%} vs 27.3{\%}) and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3{\%} vs 3.6{\%}, P < 0.05). Pretreatment splenic ISG expression was higher in patients carrying IL28B major. There was no difference in progression of anemia or thrombocytopenia between patients carrying each ITPA genotype in the Spx group. Although splenectomy did not increase hemoglobin (Hb) level, Hb decline tended to be greater in the non-Spx group. In contrast, splenectomy significantly increased platelet count (61.1 × 103/μl vs 168.7 × 103/μl, P < 0.01), which was maintained during the course of PEG-IFN/RBV therapy.Conclusions: IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.",
author = "Takashi Motomura and Ken Shirabe and Norihiro Furusyo and Tomoharu Yoshizumi and Toru Ikegami and Yuji Soejima and Tomohiko Akahoshi and Morimasa Tomikawa and Takasuke Fukuhara and Jun Hayashi and Yoshihiko Maehara",
year = "2012",
month = "11",
day = "12",
doi = "10.1186/1471-230X-12-158",
language = "English",
volume = "12",
journal = "BMC Gastroenterology",
issn = "1471-230X",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype

AU - Motomura, Takashi

AU - Shirabe, Ken

AU - Furusyo, Norihiro

AU - Yoshizumi, Tomoharu

AU - Ikegami, Toru

AU - Soejima, Yuji

AU - Akahoshi, Tomohiko

AU - Tomikawa, Morimasa

AU - Fukuhara, Takasuke

AU - Hayashi, Jun

AU - Maehara, Yoshihiko

PY - 2012/11/12

Y1 - 2012/11/12

N2 - Background: IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV) therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined.Methods: Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group) and 90 who did not (non-Spx group) were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15) and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen.Results: Sustained virological response (SVR) rate was higher in patients carrying IL28B major genotype following splenectomy (50% vs 27.3%) and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3% vs 3.6%, P < 0.05). Pretreatment splenic ISG expression was higher in patients carrying IL28B major. There was no difference in progression of anemia or thrombocytopenia between patients carrying each ITPA genotype in the Spx group. Although splenectomy did not increase hemoglobin (Hb) level, Hb decline tended to be greater in the non-Spx group. In contrast, splenectomy significantly increased platelet count (61.1 × 103/μl vs 168.7 × 103/μl, P < 0.01), which was maintained during the course of PEG-IFN/RBV therapy.Conclusions: IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.

AB - Background: IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV) therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined.Methods: Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group) and 90 who did not (non-Spx group) were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15) and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen.Results: Sustained virological response (SVR) rate was higher in patients carrying IL28B major genotype following splenectomy (50% vs 27.3%) and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3% vs 3.6%, P < 0.05). Pretreatment splenic ISG expression was higher in patients carrying IL28B major. There was no difference in progression of anemia or thrombocytopenia between patients carrying each ITPA genotype in the Spx group. Although splenectomy did not increase hemoglobin (Hb) level, Hb decline tended to be greater in the non-Spx group. In contrast, splenectomy significantly increased platelet count (61.1 × 103/μl vs 168.7 × 103/μl, P < 0.01), which was maintained during the course of PEG-IFN/RBV therapy.Conclusions: IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.

UR - http://www.scopus.com/inward/record.url?scp=84868651143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868651143&partnerID=8YFLogxK

U2 - 10.1186/1471-230X-12-158

DO - 10.1186/1471-230X-12-158

M3 - Article

VL - 12

JO - BMC Gastroenterology

JF - BMC Gastroenterology

SN - 1471-230X

M1 - 158

ER -