Validity of serum CCL11 (Eotaxin-1) and interleukin-13 as prognostic biomarkers in hepatitis C virus induced liver disease

Abstract

Hepatitis C virus (HCV) is the main cause of chronic liver disease (CLD), which affects more than 50 million people around the world. Persistent immune dysregulation promotes hepatocellular damage, fibrotic remodeling and carcinogenesis. Immune-mediated cytokines and chemokines have recently gained attention as non-invasive biomarkers for disease progression. This study aimed to assess the validity of CCL11 (Eotaxin-1) and Interleukin-13 (IL-13) as biomarkers for disease progression in chronic HCV patients. This cross-sectional study enrolled 120 participants at Alexandria Main University Hospital (AMUH) classified into four equal groups (n = 30): group I chronic HCV patients without cirrhosis, group II chronic HCV cirrhotic patients without HCC, group III chronic HCV cirrhotic patients with HCC, and group IV healthy controls. CCL11 and serum IL-13 were quantified using ELISA. Correlation analyses were performed with relevant biochemical and clinical parameters. Logistic regression analysis was conducted to assess their independent predictive value. Our data demonstrated increase in serum levels of both IL-13 and CCL11 across disease stages with significantly higher levels observed in cirrhosis and HCC compared to non-cirrhotics. IL-13 showed significant positive correlations with ascites, hepatic encephalopathy, esophageal varices, total bilirubin, INR, and FIB-4 index, while negatively correlating with serum albumin (p < 0.05). CCL11 exhibited a significant positive correlation with alpha-fetoprotein (AFP) and Child–Pugh score (p < 0.05). ROC curve analysis revealed that IL-13 showed superior diagnostic performance in discriminating cirrhotic patients from non-cirrhotic chronic HCV cases, as well as HCC patients from cirrhotic patients without HCC. CCL11 levels were higher in patients with advanced stages, with a particularly steep increase observed in the HCC group. Serum IL-13 and CCL11 levels were significantly elevated in patients with chronic HCV-related liver disease, particularly among those with HCC. Both biomarkers demonstrated acceptable discriminatory ability in identifying HCC among cirrhotic patients and remained independent predictors for HCC presence after adjustment for established clinical parameters. The combined assessment of IL-13, CCL11, and AFP may provide improved diagnostic performance in HCC detection. Further large-scale prospective studies are needed to validate our findings.