DYNAMICS OF LIVER FIBROGENESIS MARKERS IN PATIENTS WITH TUBERCULOSIS WITHOUT VIRAL HEPATITIS WITHIN THE FRONT OF TREATMENT
Keywords:
tuberculosis, drug-induced liver injury (DILI), hepatotoxicity, liver fibrosis, collagen type I, collagen type IV, fibrogenesis, non-invasive diagnosticsAbstract
While the hepatotoxicity of anti-tuberculosis therapy is well-documented, its direct impact on liver fibrogenesis requires clarification. The aim of this study was to comparatively evaluate the levels of key markers of liver fibrogenesis—collagen types I and IV—in 30 tuberculosis patients without viral hepatitis before and after standard treatment. Serum levels of collagen types I and IV were assessed by ELISA after the 2-month intensive phase of therapy. The results demonstrated a statistically significant increase in the concentration of both collagen types during treatment (p<0.001). These findings indicate that anti-tuberculosis drugs not only cause hepatocyte injury but also activate the initial stages of fibrous tissue formation in the liver. Collagen types I and IV may serve as sensitive non-invasive markers for assessing the fibrogenic potential of anti-tuberculosis therapy and for the early diagnosis of drug-induced liver injury.
References
World Health Organization. Global tuberculosis report 2024. Geneva: WHO; 2024.
Мишин В.Ю., Чуканов В.И., Васильева И.А. Лекарственно-индуцированные поражения печени при лечении туберкулеза легких. Туберкулез и болезни легких. 2017;95(8):5-13.
Choi, J. C., & Ihm, J. S. Clinical characteristics of chronic hepatitis B and tuberculosis comorbidity. Clinical and Molecular Hepatology. 2013;19(2):164-168.
Tostmann A., Boeree M.J., Aarnoutse R.E., et al. Antituberculosis drug-induced hepatotoxicity: concise up-to-date review. Journal of Gastroenterology and Hepatology. 2008;23(2):192-202.
Friedman S.L. Liver fibrosis — from bench to bedside. Journal of Hepatology. 2003;38(Suppl 1):S38-S53.
Schuppan D., Rockey D.C., Afdhal N.H. Liver fibrosis: From pathogenesis to novel therapies. Cold Spring Harbor Perspectives in Medicine. 2018;8(1):a028268.
Gressner A.M., Weiskirchen R. Modern pathogenetic concepts of liver fibrosis suggest new treatment strategies. Medical Science Monitor. 2006;12(5):RA92-RA106.
Rojkind M., Greenwel P. The liver as a generator of extracellular matrix. Gastroenterology. 1994;107(1):311-313.
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Drug-induced liver injury. Journal of Hepatology. 2019;70(6):1222-1261.
Kropf J., Gressner A.M., Negwer A. Efficacy of the serum determination of N-terminal propeptide of type III procollagen and other liver tests for the diagnostics of liver fibrosis in patients with chronic hepatitis B. Klinische Wochenschrift. 1988;66(5):199-205.
Saukkonen J.J., Cohn D.L., Jasmer R.M., et al. An official ATS statement: hepatotoxicity of antituberculosis therapy. American Journal of Respiratory and Critical Care Medicine. 2006;174(8):935-952.
Иванова Д.А., Борисов С.Е., Рыжова Л.Н. Факторы риска и структура лекарственных поражений печени у больных туберкулезом. Терапевтический архив. 2019;91(11):49-55.
