Serum type III procollagen, procollagen V, tumour necrosis factor-a, interleukin-6 in liver cirrhosis after antiviral treatment

J Med Biochem 2025; 44 (7) DOI: 10.5937/jomb0-56353 UDK 577.1 : 61 ISSN 1452-8258 J Med Biochem 44: 1478 –1486, 2025 Original paper Originalni nau~ni rad SERUM TYPE III PROCOLLAGEN, PROCOLLAGEN V, TUMOUR NECROSIS FACTOR-a, INTERLEUKIN-6 IN LIVER CIRRHOSIS AFTER ANTIVIRAL TREATMENT SERUMSKI PROKOLAGEN TIPA III, PROKOLAGEN V, FAKTOR NEKROZE TUMORA-a, INTERLEUKIN-6 KOD CIROZE JETRE NAKON ANTIVIRUSNOG LE^ENJA Wei Li, Xueshuang Liu, Fan Bi* Department of Basic Medical Education, Dazhou Vocational College of Chinese Medicine, Dazhou, 635000, Sichuan Province, China Summary Kratak sadr`aj Background: To evaluate the therapeutic effects of entecavir combined with reduced glutathione on serum type III procollagen (PCIII), plasma procollagen V (IVC), Tumour Necrosis Factor-a (TNF-a), interleukin-6 (IL-6), and nutritional status in patients with hepatitis B complicated by alcoholic liver cirrhosis. Methods: This study included 92 patients with alcoholic liver cirrhosis and hepatitis B, treated between April 2022 and January 2024. Patients were randomised into two groups: group A received 0.5 mg of entecavir daily, and group B received 0.5 mg of entecavir daily plus 0.3 g of reduced glutathione 1–2 times per day for 2 months. Nutritional parameters, inflammatory markers, liver function, and malnutrition were compared between groups. Statistical analysis was performed using SPSS12.0, with independent t-tests for group comparisons and x2 tests for categorical data. A P-value <0.05 was considered statistically significant. Results: Group B showed a higher effective treatment rate (97.82%) compared to group A (76.08%). Malnutrition improved significantly more in group B. After treatment, group B exhibited more significant reductions in BMI, TSF, AMC, PA, Hb, ALB, TNF-a, CRP, IL-6, TBIL, AST, ALT, HA, PCIII, and IVC than group A. Conclusions: Entecavir combined with reduced glutathione improves liver function and nutritional status and reduces inflammatory markers in patients with hepatitis B and alcoholic liver cirrhosis, demonstrating high safety and effectiveness. Uvod: Procena terapijskih efekata entekavira u kombinaciji sa redukovanim glutationom na serumski prokolagen tipa III (PCIII), plazmatski prokolagen V (IVC), faktor nekroze tumora-a (TNF-a), interleukin-6 (IL-6) i nutritivni status kod pacijenata sa hepatitisom B komplikovanom alkoholnom cirozom jetre. Metode: U studiju je uklju~eno 92 pacijenta sa alkoholnom cirozom jetre i hepatitisom B, le~enih u periodu od aprila 2022. do januara 2024. Pacijenti su nasumi~no raspore|eni u dve grupe: grupa A je primala 0,5 mg entekavira dnevno, dok je grupa B primala 0,5 mg entekavira dnevno uz 0,3 g redukovanog glutationa 1–2 puta dnevno tokom 2 meseca. Upore|eni su nutritivni parametri, inflamatorni markeri, funkcija jetre i stanje neuhranjenosti izme|u grupa. Statisti~ka analiza je sprovedena kori{}enjem SPSS 12.0, pri ~emu su za pore|enje grupa kori{}eni nezavisni ttestovi, a za kategorijske podatke hi-kvadrat test (x2). Pvrednost <0,05 smatrana je statisti~ki zna~ajnom. Rezultati: Grupa B je imala vi{u stopu efikasnog le~enja (97,82%) u pore|enju sa grupom A (76,08%). Neuhranjenost se zna~ajno vi{e pobolj{ala u grupi B. Nakon terapije, grupa B je pokazala ve}e smanjenje BMI, TSF, AMC, PA, Hb, ALB, TNF-a, CRP, IL-6, TBIL, AST, ALT, HA, PCIII i IVC u odnosu na grupu A. Zaklju~ak: Entekavir u kombinaciji sa redukovanim glutationom pobolj{ava funkciju jetre, nutritivni status i smanjuje inflamatorne markere kod pacijenata sa hepatitisom B i alkoholnom cirozom jetre, pokazuju}i visoku bezbednost i efikasnost. Address for correspondence: Fan Bi Department of Basic Medical Education, Dazhou Vocational College of Chinese Medicine, Dazhou, 635000, Sichuan Province, China e-mail: bifan110411ª163.com List of abbreviations: BMI, body mass index; TSF, triceps skinfold thickness; AMC, arm muscle circumference; PA, prealbumin; HB, haemoglobin; ALB, albumin; TNF-a, tumour necrosis factor-a; IL-6, interleukin-6; CRP, C-reactive protein; TBIL, total bilirubin; AST, aspartate aminotransferase; ALT, alanine aminotransferase; HA, hyaluronic acid; PCIII, procollagen type III; IVC, procollagen type V; HBV, hepatitis B virus; SGA, subjective global assessment; PA, proalbumin; SPSS, statistical package for the social sciences. 1479 Li et al.: Serum PCIII, procollagen V TNF-a, IL-6 in cirrhosis Keywords: serum type III procollagen (PCIII), plasma procollagen V (IVC), tumour necrosis factor-a (TNF-a), interleukin-6 (IL-6), entecavir, reduced glutathione, alcoholic cirrhosis, hepatitis B, clinical effects, nutritional status Introduction Hepatitis B (HB) is a chronic viral infection that primarily affects the liver, leading to inflammation and potential long-term damage. If untreated, HB can progress to cirrhosis, liver failure, or even liver cancer (1). Alcoholic liver cirrhosis, which results from prolonged and excessive alcohol consumption, is characterised by severe liver fibrosis and scarring (2). When both conditions co-occur, the liver is under increased stress, leading to more severe liver dysfunction and a higher risk of complications such as malnutrition, fatigue, and decreased life expectancy (3). Therefore, managing both hepatitis B and alcoholic liver cirrhosis requires a multifaceted approach to improve liver function, control inflammation, and address nutritional deficiencies. Entecavir is an effective antiviral agent that suppresses hepatitis B virus (HBV) replication and reduces liver inflammation, making it a cornerstone of Hb treatment (4). However, for patients with both Hb and alcoholic cirrhosis, antiviral therapy alone may not be sufficient to fully restore liver function, reduce fibrosis, or address the complex nutritional issues that often arise from liver dysfunction. In these patients, liver injury is compounded by oxidative stress and inflammation, which not only exacerbates liver damage but also impairs nutritional absorption and metabolism (5). Reduced glutathione, a potent antioxidant, plays a vital role in reducing oxidative stress and protecting liver cells from further damage. By scavenging free radicals and aiding in the repair of damaged liver cells, glutathione helps mitigate the detrimental effects of both HBV infection and alcohol-induced liver injury (6). Given its protective role, some researchers have proposed that combining entecavir with reduced glutathione may offer a synergistic effect – entecavir suppresses viral replication while glutathione promotes liver regeneration and reduces oxidative damage. This combination could theoretically improve liver function, reduce inflammation, and support nutritional recovery in patients with both hepatitis B and alcoholic cirrhosis. Despite the potential benefits of this combined approach, there is a gap in the existing literature regarding its impact on the nutritional status and overall quality of life in these patients. While much of the research has focus (...truncated)