The Use of Cytokeratin 18 as a Biomarker for Early Detection of Toxicant-Associated Steatohepatitis among Workers in Paint Industry

Introduction: Volatile organic compounds (VOCs) are used as solvents in the paint industry. Industrial exposure to VOCs, have been associated with toxicant-associated steatohepatitis (TASH) due to necrosis of liver cells. Cytokeratin 18 (CK18) is an intermediate filament protein highly expressed by the liver. Recently (CK18) M65 and M30 are used as alternative noninvasive biological markers for detection of liver injury due to chemical exposures. Aim of Work: To evaluate the use of Cytokeratin 18 (CK18 M65 and CK18M30) for early detection of Toxicant-Associated Steatohepatitis (TASH) among workers exposed to volatile organic compounds in the paint industry. Materials and Methods: This cross section comparative study included 46 exposed workers and 46 nonexposed office workers as control. History, clinical examination, AST, ALT, GGT, CK18 M65, and CK18 M30 were examined for both groups. Environmental study was done. Results: All environmental samples revealed high levels of VOCs and poor Indoor Air Quality (IAQ). AST, ALT, GGT were significantly higher among exposed workers but AST and ALT were still within normal range. CK18M65 was significantly higher among the exposed group compared to non exposed (599.2 ±193.9, 240 ± 51.8, respectively), while CK18M30 showed no significant difference (165.39 ± 34.57, 156.33 ± 16.1, respectively), between both groups. CK18M30/CK18M65 was significantly lower among the exposed group compared to non exposed (26.01± 3.75, 62.95± 5.54, respectively). CK18 M65 correlated positively with duration of exposure, ALT and GGT among exposed workers. Conclusion: Cytokeratin18 can be used as biomarkers for early detection of TASH among paint workers.Recommendations:Toxicant Associated-Steotohepatitis should be considered among non obese , non alcoholic workers exposed to volatile organic compounds in the paint industry.