TNF-α messenger ribonucleic acid (mRNA) in patients with nonalcoholic steatohepatitis

Background and aim: tumor necrosis factor (TNF)-alpha plays a significant role in the pathogenesis of nonalcoholic steatohepatitis (NASH). A few studies have confirmed high TNF-alpha plasma protein levels in patients with NASH compared to healthy volunteers. We herein aimed to revisit these findings using other molecular techniques. Methods: a cross-sectional evaluation of patients newly diagnosed with NASH. A quantitative assay for the measurement of TNF-alpha messenger ribonucleic acid (mRNA) was performed for NASH patients and controls using real-time reverse transcription polymerase chain reaction (RT-PCR). Results: in 39 patients with NASH (mean age 38.6 +/- 9.4 years, range 28-60 years; 79% males), the mean TNF-alpha mRNA level was significantly higher than that found for controls (137.6 +/- 102.3 ng/mL versus 83.5 +/- 43.8 ng/mL, respectively; P = 0.012). A TNF-alpha mRNA cut-off of 100 ng/mL predicted NASH most optimally (AUC 0.685 +/- 0.066, P = 0.01; with 66.7% sensitivity and 74.1% specificity). Serum TNF-alpha and soluble TNF-alpha receptor II (sTNFRII) levels were significantly higher in patients compared to controls using ELISA. Conclusion: high TNF-alpha mRNA levels, determined by RT-PCR, characterize patients with NASH.