Transforming growth factor-β1, connective tissue growth factor, and inducible nitric oxide synthesase in hepatitis C-positive chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma in Upper Egypt

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Egypt has the highest prevalence of hepatitis C worldwide, which is considered a major cause of chronic hepatitis (CH), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). Transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), and inducible nitric oxide synthesase (iNOS) seem to play important roles in LC and carcinoma. Inhibiting fibrogenesis is very important, and the list of target cytokines involved is growing. TGF-β1, CTGF, and iNOS are potential therapeutic targets for the treatment of liver fibrosis and inhibiting subsequent carcinogenesis. Knowledge regarding these aspects would help researchers to develop effective therapeutic strategies with minimal off-target effects.


In this study, we aimed to study the pattern of TGF-β1, CTGF, and iNOS expression in hepatitis C-positive CH, cirrhosis, and HCC patients in Upper Egypt to assess their role and possibility of their use as potential therapeutic targets.

Patients and methods

Twenty-four hepatitis C-positive HCC, 30 CH C, and six unremarkable liver tissues were retrieved from Assiut University Hospitals. The expressions of TGF-β1, CTGF, and iNOS were studied using immunohistochemistry.


There was significant upregulation in the expressions of TGF-β1, CTGF, and iNOS in different stages of fibrosis of CH. In addition, there were significant differences in their expressions between HCC and both control and CH.


The upregulation of these proteins suggests their role in development of LC and carcinoma. Therefore, TGF-β1, CTGF, and iNOS are possible potential therapeutic targets for LC and HCC.

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