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Effect of misoprostol on serum beta2-microglobulin in the course of viral hepatitis B.

OBJECTIVE
Beta2-microglobulin (beta2-m), as part of the HLA-I complex, is responsible for transportation of the viral antigens on the hepatocyte surface. Misoprostol and other prostaglandin analogues have been found to protect the liver against injury of various origins.


DESIGN
The study was undertaken to evaluate whether the profitable effect of misoprostol on viral hepatitis B is related to beta2-m serum concentration, as a marker of viral expression.


METHODS
Thirty-one male patients with viral hepatitis B were assigned at random into groups treated with misoprostol or silymarin (control group). Biochemical indices of liver injury and concentration of beta2-m were measured once a week.


RESULTS
Decreases in the serum concentration of bilirubin and activity of alanine transaminase were faster in misoprostol-treated patients, resulting in significantly shorter hospitalization. The mean serum concentration of beta2-m was the highest at the beginning of the study and decreased more slowly in patients treated with misoprostol. However, in the third week of the disease they demonstrated very fast normalization, whereas values in controls remained significantly higher than normal beta2-m concentration. There were no side-effects related to either misoprostol or silymarin treatment.


CONCLUSIONS
These data confirm the beneficial effect of misoprostol treatment in patients with viral hepatitis B. A possible mechanism of action seems to be its effect on serum concentration of beta2-m, related to antigen presentation on the hepatocyte surface.