Tissue factor expression on blood monocytes in patients with hepatitis C virus-induced chronic liver disease

Chronic liver disease (CLD) is a worldwide common pathology characterised by an inflammatory and fibrotic process leading to progressive evolution from chronic hepatitis to cirrhosis. Monocytes play a crucial role in the pathogenesis of inflammation and fibrosis in chronic liver diseases. Activated monocytes increase the expression of tissue factor, a key glycoprotein that participates in haemostatic and inflammatory processes. This study aims to assess the expression of tissue factor on activated peripheral blood monocytes in patients with hepatitis C virus (HCV)-induced CLD in relation to the degree of hepatic insufficiency and haemostatic imbalance. The current study included 60 patients with HCV-induced CLD, categorised after Child–Pugh into four groups: Child A, B, C and C during acute attack of haematemesis, 15 patients each, and 15 healthy subjects were included as normal controls. Immunophenotype characterization was carried out by flow cytometric analysis for identification of monocytes tissue factor expression (CD142) on activated blood monocytes population (CD11b and CD14) in different groups studied. Data demonstrated significant increase (p < 0.05) in the expression of each of CD11b, CD14 and CD142 revealing monocytes activation and increased expression of tissue factor on peripheral blood monocytes in different groups of patients especially cases during acute attack of haematemesis, compared to healthy subjects. Increased monocytes tissue factor expression in patients with HCV may play a key role in the intensification of the inflammatory and immunological processes in conjunction with activation of the coagulation mechanisms. The interaction of all these phenomena may trigger bleeding by perturbing the unstable haemostasis in frail patients with chronic liver disease.