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Yu D, Yin G, Lei J, Gong Y, Zheng L, He D, Lei L, Sun L. The correlation between serum levels of laminin, type IV collagen, type III procollagen N-terminal peptide and hyaluronic acid with the progression of post-COVID-19 pulmonary fibrosis. Front Cell Dev Biol 2024; 12:1382244. [PMID: 38979035 PMCID: PMC11228261 DOI: 10.3389/fcell.2024.1382244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/30/2024] [Indexed: 07/10/2024] Open
Abstract
COVID-19 patients often suffer from post-COVID-19 acute sequelae (PASC). Pulmonary fibrosis has the most significant long-term impact on the respiratory health of patients, known as post-COVID-19 pulmonary fibrosis (PC19-PF). PC19-PF can be caused by acute respiratory distress syndrome (ARDS) or COVID-19-induced pneumonia. Individuals who experience COVID-19 pneumonia symptoms (including cough, shortness of breath, dyspnea on exertion, and desaturation) for at least 12 weeks after diagnosis, almost all develop PC19-PF. Extracellular matrix molecules: laminin (LN), type IV collagen (IV Col), procollagen III N-terminal peptide (PIIINP), and hyaluronic acid (HA) are involved in the development and progression of PC19-PF. This study aimed to investigate the relationship between the progression of PC19-PF and serum levels of laminin, IV COL, PIIINP, and hyaluronic acid. This retrospective study included 162 PC19-PF patients treated and 160 healthy controls who received treatment at Shenzhen Longgang District Third People's Hospital, Hebei PetroChina Central Hospital and Changzhi People's Hospital from January 2021 to December 2023. Serum levels of LN, IV COL, PIIINP, and HA were detected by chemiluminescence immunoassay using commercial kits. Predicted forced vital capacity percentage (FVC% pred), predicted carbon monoxide lung diffusion capacity percentage (DLCO% pred), high-resolution computed tomography (HRCT) scores were assessed, and patient mortality was compared with healthy controls. Serum levels of LN, IV Col, PIIINP, and HA were significantly higher in PC19-PF or CTD-ILD patients than in healthy controls (all p < 0.05), and they were further elevated in acute exacerbation cases (all p < 0.01). In patients, HA was positively associated with HRCT scores and negatively associated with FVC% pred and DLCO% pred (all p < 0.05). Serum levels of LN, IV COL, PIIINP, and HA were significantly lower in surviving patients than in those who deceased (all p > 0.05). Serum levels of LN, IV C, PIIINP, and HA may affect the progression of PC19-PF and may serve as indicators of PC19-PF severity.
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Affiliation(s)
- Dapeng Yu
- School of Basic Medical Sciences, Guangdong Medical University, Dongguan, China
| | - Guangyue Yin
- Department of Clinical Laboratory, Hebei Petro China Central Hospital, Langfang, China
| | - Jing Lei
- School of Medical Technology, Guangdong Medical University, Dongguan, China
| | - Yijun Gong
- Guangdong Provincial Engineering Technology Research Center for Autoimmune Laboratory Diagnostic Products, Shenzhen, China
| | - Liang Zheng
- Guangdong Provincial Engineering Technology Research Center for Autoimmune Laboratory Diagnostic Products, Shenzhen, China
| | - Dahui He
- Department of Clinical Laboratory, Shenzhen Longgang District Third People's Hospital, Shenzhen, China
| | - Lihua Lei
- Department of Clinical Laboratory, Huaiji County Traditional Chinese Medicine Hospital, Zhaoqing, China
| | - Lei Sun
- Department of Clinical Laboratory, Changzhi People's Hospital, Changzhi, China
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Yang X, Liao L, Liang Z, Yu S, Guo Z. Correlation Analysis of IL-17, IL-21, IL-23 with Non-Alcoholic Liver Fibrosis and Cirrhosis. J Inflamm Res 2024; 17:2327-2335. [PMID: 38651006 PMCID: PMC11033842 DOI: 10.2147/jir.s452061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
Objective This research aimed to explore the involvement of interleukins (IL) - IL-6, IL-17, IL-21, and IL-23 - in the evolution and diagnosis of non-alcoholic liver fibrosis and cirrhosis. Methods The study subjects were selected from the patients who visited the Department of Hepatology of X Hospital in Y City from August 2021 to April 2023. Peripheral blood samples were collected. All participants were divided into liver fibrosis, cirrhosis, hepatitis, and healthy subjects four groups. IL-21, IL-17, IL23, IL-6 were detected by double antibody sandwich. Results The results showed that there was a significant difference in the levels of IL-17, IL-21, and IL-23 among the 4 groups (P<0.0001). ROC curve analysis showed that the AUC values of IL-17, IL-21 and liver fiber 4 items were >0.70, suggesting that the diagnostic efficacy of IL-17, IL-21 was similar to that of liver fiber 4 items. Spearman correlation analysis showed that IL-17 had a positive correlation with collagen type III N-peptide, type IV collagen, and Laminin (P < 0.05), and no correlation with Hyaluronic acid (P > 0.05). Conclusion IL-17, IL-21, and IL-23 play a pivotal role in the inflammatory pathways associated with liver injuries, establishing themselves as potent auxiliary diagnostic markers in identifying liver fibrosis and cirrhosis.
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Affiliation(s)
- Xiaoyan Yang
- Department of Laboratory Medicine, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, People’s Republic of China
| | - Liyin Liao
- Department of Laboratory Medicine, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, People’s Republic of China
| | - Zizhen Liang
- Department of Laboratory Medicine, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, People’s Republic of China
| | - Shenglong Yu
- Institute of Cardiovascular Medicine, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, People’s Republic of China
| | - Zhonghui Guo
- Department of Laboratory Medicine, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou, 511400, People’s Republic of China
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Gao TM, Jin SJ, Fang F, Qian JJ, Zhang C, Zhou BH, Bai DS, Jiang GQ. Novel Preoperative Type IV Collagen to Predict the Risk of Hepatocellular Carcinoma in Patients with Hepatitis B Virus-Related Cirrhotic Portal Hypertension After Laparoscopic Splenectomy and Azygoportal Disconnection. J Hepatocell Carcinoma 2024; 10:2411-2420. [PMID: 38260186 PMCID: PMC10801173 DOI: 10.2147/jhc.s425814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/15/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose Although laparoscopic splenectomy and azygoportal disconnection (LSD) can significantly decrease portal vein pressure and even the incidence of hepatocellular carcinoma (HCC) in patients with cirrhotic portal hypertension (CPH), postoperative HCC inevitably occurs in certain patients. The purpose of this study was to seek a novel preoperative non-invasive predictive indicator to predict the occurrence of postoperative HCC. Patients and Methods From April 2012 to April 2022, we collected clinical data of 178 hepatitis B virus (HBV)-related CPH patients. Based on inverse treatment probability weighting, candidate variables for predicting postoperative HCC were determined by means analysis. Then, a novel preoperative non-invasive prediction indicator (ie, type IV collagen-alpha fetoprotein-fibrosis-4 score [IVAF-FIB-4]) was established based on candidate variables, and its predictive ability was explored. Results Postoperative HCC occurred in 9 (5.1%) patients. Correlation analyses showed that the IVAF-FIB-4 had a significant positive correlation with HCC (r = 0.835, P < 0.001). IVAF-FIB-4 showed a high accuracy (the area under the receiver operating characteristic curve: 0.939, 95% confidence interval [CI]: 0.818-1.000; sensitivity: 88.9%; specificity: 93.5%). At the end of follow-up, the incidence density of HCC in patients with IVAF-FIB-4 (1) was significant higher than that in patients with IVAF-FIB-4 (0) (138.1/1000 vs 1.1/1000 person-years; rate ratio: 130.475, 95% CI: 16.318-1043.227). In logistic regression, IVAF-FIB-4 was an independent risk factor for HCC (odds ratio: 668.000, 95% CI: 53.895-8279.541; P < 0.001). Conclusion IVAF-FIB-4 is a novel preoperative noninvasive predictive indicator for predicting postoperative HCC in HBV-related CPH patients after LSD, with satisfactory predictive ability.
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Affiliation(s)
- Tian-Ming Gao
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Sheng-Jie Jin
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Fang Fang
- Department of Gastrointestinal Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Jian-Jun Qian
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Chi Zhang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Bao-Huan Zhou
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Dou-Sheng Bai
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
| | - Guo-Qing Jiang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, People’s Republic of China
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Chen Q, Mei L, Zhong R, Han P, Wen J, Han X, Zhai L, Zhao L, Li J. Serum liver fibrosis markers predict hepatic decompensation in compensated cirrhosis. BMC Gastroenterol 2023; 23:317. [PMID: 37726681 PMCID: PMC10510279 DOI: 10.1186/s12876-023-02877-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/10/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND AND AIM The literature is sparse on the association between serum liver fibrosis markers and the development of hepatic decompensation in patients with compensated cirrhosis. We aimed to assessed whether the serum liver fibrosis markers are predictive of the occurrence of hepatic decompensation. METHODS We ascertained 688 cirrhotic patients with varying etiologies, between December 2015 to December 2019. Serum hyaluronic acid (HA), laminin (LN), collagen IV (CIV), and N-terminal propeptide of type III collagen (PIIINP) levels were measured at enrollment. All subjects were followed for at least 6 months for occurrence of hepatic decompensation. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of hepatic decompensation during follow-up. RESULTS During a median follow-up of 22.0 (13.0-32.0) months, decompensation occurred in 69 (10.0%) patients. Multivariate analysis indicated that higher LN (HR: 1.008, 95% confidence interval [CI]: 1.002-1.014, P = 0.011) and CIV (HR: 1.004, 95% CI: 1.001-1.007, P = 0.003) levels were independently associated with hepatic decompensation. Furthermore, patients in the tertile 2 and tertile 3 groups for CIV levels had HRs of 4.787 (1.419, 16.152) (P = 0.012) and 5.153 (1.508, 17.604) (P = 0.009), respectively, for occurrence of decompensation event compared with those in the tertile 1 group. CONCLUSION Serum liver fibrosis markers, particularly in CIV, appeared to be reliable biomarkers of disease progression and liver decompensation in patients with compensated cirrhosis with varying etiologies.
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Affiliation(s)
- Qingling Chen
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Ling Mei
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Rui Zhong
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ping Han
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Jun Wen
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Xu Han
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Lu Zhai
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Lili Zhao
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China.
| | - Jia Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China.
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Komarowska M, Kowalska M, Grubczak K, Pawelczyk A, Hermanowicz A, Debek W, Matuszczak E. Situation of Pediatric Patients with Testicular Torsion in Times of COVID-19. Emerg Med Int 2023; 2023:9960452. [PMID: 37197364 PMCID: PMC10185415 DOI: 10.1155/2023/9960452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/23/2023] [Accepted: 04/23/2023] [Indexed: 05/19/2023] Open
Abstract
PURPOSE To assess whether the COVID-19 pandemic had an influence on presentation of testicular torsion and/or increase in the frequency of orchiectomy. Patients and Methods. This retrospective study included boys under 18 years of age with testicular torsion divided in two groups: pre-COVID operated in 2019 vs. COVID-19 group from 2020. We compared demographic data as well as local and general symptoms. We analyzed additional tests, intraoperative findings, length of operation and hospitalization, and followup. Results. We analyzed the data collected from 44 patients (24 boys from first group vs. 20 boys from second group). The median age was 13.4 years vs. 14.5 years in the latter. The median time of symptoms duration was 6.5 hours and 8.5 hours, respectively. The main manifestation was testicular pain without additional signs. The results of the laboratory tests did not reflect local advancement. In the 2019 group, Doppler ultrasound showed absent blood flow in the affected testicle in 62% vs. 80% in 2020. The mean time from admission to surgery was virtually identical: 75 minutes in 2019 vs. 76 minutes in 2020. The mean duration of scrotal revision was similar in both groups. There was only one significant difference: the degree of twisting. In 2019, the mean was 360° vs. 540° in 2020. Incidence of orchiectomy also did not significantly vary between the analyzed time periods, with 21% during the pandemic and 35% during the pre-COVID-19 period. Conclusion. We did not observe an increase in the number of testicular torsion cases during the COVID-19 pandemic. Most importantly, the rates of orchiectomy did not significantly differ between the patients with testicular torsion presenting during the COVID-19 outbreak.
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Affiliation(s)
- Marta Komarowska
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Małgorzata Kowalska
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Kamil Grubczak
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Alicja Pawelczyk
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Adam Hermanowicz
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Wojciech Debek
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Ewa Matuszczak
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
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Mei L, Ma Y, Zhao L, Chen Q, Zhou L, Yang H, Liu J, Li J. Correlation between serum liver fibrosis markers and early gastroesophageal varices among patients with compensated liver cirrhosis: a cross-sectional analysis. BMC Gastroenterol 2022; 22:515. [PMID: 36510159 PMCID: PMC9746016 DOI: 10.1186/s12876-022-02546-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/19/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIM Portal hypertension is a common complication of chronic liver diseases responsible for most liver cirrhosis consequences. In patients with portal hypertension, oesophagogastric variceal bleeding is a leading cause of death. Most research has focused on high-risk gastroesophageal varices and bleeding, with only a few studies on early varices. However, early intervention of gastroesophageal varices was found to better improve the prognosis and reduce mortality, but there is still no relevant research. Ultrasonic endoscopy is a combination of endoscopy and ultrasonic imaging. It can gastroscopically detect varices around the oesophagus and stomach and detect oesophageal collateral veins and perforating veins earlier, which is helpful for the early diagnosis of varices. Therefore, this study aimed to explore the correlation between serum fibrosis markers and early gastroesophageal varices in compensated cirrhosis patients. METHODS This study included 791 patients with compensated cirrhosis. The selected patients were categorized into three groups. The early gastroesophageal varices group included patients with gastroesophageal varices found by endoscopic ultrasonography but not by gastroscopy. The no gastroesophageal varices group underwent endoscopic ultrasonography and gastroscopy without varices. In addition, gastroesophageal varices can be detected with both techniques. Multiple logistic regression analysis explored the association of serum fibrosis markers with early gastroesophageal varices. RESULTS Among the 791 compensated liver cirrhosis patients, 198 patients were without gastroesophageal varices, 279 patients had early gastroesophageal varices, 314 patients had gastroesophageal varices, and both techniques could detect varices. There was a positive correlation between serum fibrosis markers and early gastroesophageal varices. In univariate logistic regression analysis, the patients with early gastroesophageal varices had lower platelet counts (P = 0.034) and higher aspartate aminotransferase (P = 0.046), total bilirubin (P = 0.041), hyaluronic acid (P < 0.001), laminin (P < 0.001), type III procollagen (P = 0.005), type IV collagen (P = 0.002), liver stiffness measurement (P = 0.001), APRI (P = 0.019) and FIB-4 (P = 0.002). Multivariate analysis showed that laminin (OR 1.011; 95% CI 1.004-1.017, P = 0.001) was an independent risk factor for predicting early gastroesophageal varices in compensated cirrhosis patients. CONCLUSION Higher laminin was independently associated with early gastroesophageal varices in compensated cirrhosis patients.
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Affiliation(s)
- Ling Mei
- grid.265021.20000 0000 9792 1228Department of Gastroenterology and Hepatology, Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, China ,Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Ying Ma
- grid.265021.20000 0000 9792 1228Department of Gastroenterology and Hepatology, Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, China ,Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Lili Zhao
- Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Qingling Chen
- grid.265021.20000 0000 9792 1228Department of Gastroenterology and Hepatology, Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, China ,Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Li Zhou
- Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Hang Yang
- grid.265021.20000 0000 9792 1228Department of Gastroenterology and Hepatology, Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin, China ,Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Jie Liu
- Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
| | - Jia Li
- Department of Hepatology, Tianjin Second People’s Hospital, No. 7, Sudi South Road, Nankai District, Tianjin, 300192 China
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Banys V, Aleknavičiūtė-Valienė G. Clinical importance of laboratory biomarkers in liver fibrosis. Biochem Med (Zagreb) 2022; 32:030501. [PMID: 36277426 PMCID: PMC9562801 DOI: 10.11613/bm.2022.030501] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Hepatic cirrhosis is a major health problem across the world, causing high morbidity and mortality. This disease has many etiologies, yet the result of chronic hepatic injury is hepatic fibrosis causing cirrhosis and hepatocellular carcinoma, as the liver’s architecture is progressively destroyed. While liver biopsy is currently the gold standard for fibrosis staging, it has significant disadvantages, leading to a growing interest in non-invasive markers. Direct biomarkers – hyaluronic acid, laminin, collagen type III N-peptide, type IV collagen and cholylglycine – are new and rarely applied in routine clinical practice. This is the case primarily because there is no general consensus regarding the clinical application and effectiveness of the individual biomarkers. The usage of these markers in routine clinical practice could be advantageous for patients with liver fibrosis, requiring a simple blood test instead of a biopsy. The former option would be especially attractive for patients who are contraindicated for the latter. This review summarizes recent findings on direct biomarkers of liver fibrosis and highlights their possible applications and potential benefit for liver fibrosis diagnostics and/or staging.
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Affiliation(s)
- Valdas Banys
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Zhang C, Zhang C. Analysis of current status of quantitative detection of biomarkers for liver fibrosis in Clinical labs in China. J Clin Lab Anal 2022; 36:e24490. [PMID: 35587485 PMCID: PMC9279982 DOI: 10.1002/jcla.24490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 05/01/2022] [Indexed: 01/03/2023] Open
Abstract
Aim To explore the quality control and implementation of the quantitative detection of liver fibrosis biomarkers, laminin (LN), collagen IV (Col Ⅳ), procollagen III amino‐terminal propeptide (PⅢNP), hyaluronic acid (HA), and cholyglycine (CG), in China. Methods Two quality control products were measured in different laboratories using different measurement methods and reagents, and the acquired results were subjected to analysis. The quantitative detection technique was based on the conventional assessment criteria, with a target value ±30% being employed. Results Hundred labs were involved in the External Quality Assessment with 88 laboratories completing the assessment, and the pass rates were 84%, 80.2%, 67.5%, 77.3%, and 58.3% for HA, LN, PⅢNP, Col Ⅳ, and CG, respectively. Chemiluminescence immunoassay was used most for HA (90.1%), LN (90.1%), PⅢNP (87.9%), and Col Ⅳ (82.9%) determination, whereas the chemiluminescence immunoassay (31.6%), latex‐enhanced immunoturbidimetry (36.7%), and homogeneous enzyme immunoassay (26.7%) were used for CG determination. The coefficients of variation for HA, LN, PⅢNP, Col Ⅳ, and CG in different laboratories were 3.3%–19.49%, 1.74%–38.81%, 1.97%–41.29%, 2.85%–41.69%, and 2.71%–41.8%, respectively. Conclusion The clinical quantitative detection of liver fibrosis biomarkers is highly performed in China. The existing problems are that there are many manufacturers producing reagents and instruments, the quality of reagents is uneven, the specificity and sensitivity of reagents are greatly different, the comparability of results of various systems is poor, and the accuracy and consistency between different systems are lacking. All above underscores the critical importance of EQA in improving and monitoring the identification of biomarkers for liver fibrosis.
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Affiliation(s)
- Chao Zhang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China
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Numao H, Shimaya K, Kakuta A, Shibutani K, Igarashi S, Hasui K, Hanabata N, Kanazawa K, Munakata M. The utility of two-dimensional real-time shear wave elastography for assessing liver fibrosis in patients with chronic hepatitis C virus infection. Eur J Gastroenterol Hepatol 2021; 33:1400-1407. [PMID: 32804841 DOI: 10.1097/meg.0000000000001887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Two-dimensional shear wave elastography (2D-SWE) is a new ultrasound-based elastography method to evaluate liver fibrosis in the daily practice. However, the utility of 2D-SWE among the other liver fibrosis markers is unclear. METHODS We enrolled 141 consecutive patients with hepatitis C virus infection, 66 men and 75 women (median age, 67 years), who underwent liver biopsy and 2D-SWE (LOGIQ E9, GE Healthcare, Wauwatosa, WI, USA). We compared the diagnostic accuracy of the 2D-SWE with those of magnetic resonance elastography (MRE; MR-Touch, GE Healthcare, Milwaukee, WI, USA), Mac-2 binding protein glycosylation isomer (M2BPGi), fibrosis-4 index (FIB-4) and platelet counts (PLT), using the histologic METAVIR scoring as the reference standard. RESULTS The areas under the receiver operating characteristics curves (AUROCs) of 2D-SWE, MRE, M2BPGi, FIB-4 and PLT for ≥F2, ≥F3 and F4 were 0.86, 0.88, 0.79, 0.81 and 0.77; 0.92, 0.93, 0.86, 0.87 and 0.83; and 0.91, 0.97, 0.85, 0.85 and 0.82, respectively. For diagnosing ≥F2 and ≥F3, the AUROCs of 2D-SWE and those of MRE showed no significant differences, and both 2D-SWE and MRE showed significantly higher AUROCs than the other markers. For diagnosing F4, the AUROC of MRE was significantly higher than those of other fibrosis markers. CONCLUSION 2D-SWE has an excellent diagnostic accuracy equivalent to that of MRE for assessing significant (≥F2) and severe (≥F3) fibrosis. MRE demonstrated a higher AUROC than 2D-SWE, but this last one has advantages such as lower cost, fewer contraindications and greater ease of performance than MRE.
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Affiliation(s)
- Hiroshi Numao
- Department of Gastroenterology, Aomori Prefectural Central Hospital
| | - Koji Shimaya
- Department of Gastroenterology, Aomori Prefectural Central Hospital
- Department of Gastroenterology, Hematology, and Rheumatology, Hirosaki University school of medicine
| | - Akihisa Kakuta
- Department of Radiology, Aomori Prefectural Central Hospital, Japan
| | - Koichi Shibutani
- Department of Radiology, Aomori Prefectural Central Hospital, Japan
| | - Syohei Igarashi
- Department of Gastroenterology, Hematology, and Rheumatology, Hirosaki University school of medicine
| | - Keisuke Hasui
- Department of Gastroenterology, Hematology, and Rheumatology, Hirosaki University school of medicine
| | | | - Kosuke Kanazawa
- Department of Gastroenterology, Aomori Prefectural Central Hospital
| | - Masaki Munakata
- Department of Gastroenterology, Aomori Prefectural Central Hospital
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Ding R, Lu W, Zhou X, Huang D, Wang Y, Li X, Yan L, Lin W, Song S, Zhang Z, Chen L. A Novel Non-invasive Model Based on GPR for the Prediction of Liver Fibrosis in Patients With Chronic Hepatitis B. Front Med (Lausanne) 2021; 8:727706. [PMID: 34631748 PMCID: PMC8495242 DOI: 10.3389/fmed.2021.727706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/30/2021] [Indexed: 12/07/2022] Open
Abstract
Background: Some controversy remains regarding conventional serum indices for the evaluation of liver fibrosis. Therefore, we aimed to combine the existing index with other serum parameters to discriminate liver fibrosis stages in patients with chronic hepatitis B (CHB). Methods: A total of 1,622 treatment-naïve CHB patients were divided into training (n = 1,211) and validation (n = 451) cohorts. Liver histology was assessed according to the Scheuer scoring scheme. All common demographic and clinical parameters were analyzed. Results: By utilizing the results of the logistic regression analysis, we developed a novel index, the product of GPR, international normalized ratio (INR), and type IV collagen (GIVPR), to discriminate liver fibrosis. In the training group, the areas under the ROCs (AUROCs) of GIVPR, APRI, FIB-4, and GPR for significant fibrosis were 0.81, 0.75, 0.72, and 0.77, respectively; the AUROCs of GIVPR, APRI, FIB-4, and GPR for advanced fibrosis were 0.82, 0.74, 0.74, and 0.78, respectively; and the AUROCs of GIVPR, APRI, FIB-4, and GPR for cirrhosis were 0.87, 0.78, 0.78, and 0.83, respectively. Similar results were also obtained in the validation group. Furthermore, the decision curve analysis suggested that GIVPR represented superior clinical benefits in both independent cohorts. Conclusion: The GIVPR constructed on GPR represents a superior predictive model for discriminating liver fibrosis in CHB patients.
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Affiliation(s)
- Rongrong Ding
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wei Lu
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xinlan Zhou
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Dan Huang
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yanbing Wang
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xiufen Li
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Yan
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Weijia Lin
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Shu Song
- Department of Pathology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhanqing Zhang
- Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Liang Chen
- Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Wu LF, Xiang XX, Bai DS, Jin SJ, Zhang C, Zhou BH, Qian JJ, Jiang GQ. Novel noninvasive liver fibrotic markers to predict postoperative re-bleeding after laparoscopic splenectomy and azygoportal disconnection: a 1-year prospective study. Surg Endosc 2020; 35:6158-6165. [PMID: 33094827 DOI: 10.1007/s00464-020-08111-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Esophagogastric variceal re-bleeding (EGVR) is a common and potentially lethal complication after open or laparoscopic splenectomy and azygoportal disconnection (LSD) in patients with cirrhosis and portal hypertension. Currently, noninvasive biomarkers for predicting EGVR are lacking. This prospective study focused on developing a noninvasive and convenient clinical model for predicting postoperative EGVR. METHODS Between September 2014 and March 2017, we enrolled 164 patients with cirrhosis who successfully underwent LSD. Based on the absence or presence of EGVR, patients were divided into EGVR and non-EGVR groups. We used correlation analysis to determine significant candidate variables among the liver fibrotic markers procollagen type III (PC-III), hyaluronidase (HA), laminin (LN), and type IV collagen (C-IV). RESULTS Postoperative EGVR occurred in 22 (13.41%) patients. Correlation analyses showed that LN (r = 0.375; p < 0.001) and C-IV (r = 0.349; p < 0.001) were significantly positively associated with EGVR. The area under the receiver operating characteristic curve (AUC) of LN was 0.817 (95% confidence interval [CI] 0.722-0.913); that of C-IV was 0.795 (95% CI 0.710-0.881). In logistic multivariate regression, cutoff values LN ≥ 64 µg/L and of C-IV ≥ 65 µg/L were independent risk factors for EGVR. LN ≥ 64 µg/L combined with C-IV ≥ 65 µg/L was the best performing model, with AUC 0.867 (95% CI 0.768-0.967). CONCLUSION LN and C-IV are potential markers to predict EGVR. Combining the two markers showed satisfactory ability to predict EGVR in patients with cirrhosis and portal hypertension after LSD.
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Affiliation(s)
- Long-Fei Wu
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China.,Department of Hepatobiliary Surgery, The First Clinical College, Dalian Medical University, Dalian, China
| | - Xiao-Xing Xiang
- Department of Digestive Diseases, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Dou-Sheng Bai
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Sheng-Jie Jin
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Chi Zhang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Bao-Huan Zhou
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Jian-Jun Qian
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Guo-Qing Jiang
- Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225000, Jiangsu, China.
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Diagnostic performance of extrinsic apoptosis pathway in hepatitis C virus patients: apoptosis fibrosis crosstalk. Eur J Gastroenterol Hepatol 2020; 32:990-997. [PMID: 31743229 DOI: 10.1097/meg.0000000000001603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIM Liver fibrosis assessment and evaluation of disease severity in hepatitis C virus (HCV) patients provides useful information for therapeutic decisions. Chronic HCV infection is associated with increased levels of peripheral T cell apoptosis. The aim was to study whether peripheral blood T lymphocyte apoptosis markers may contribute to clinical progression, and develop a simple index based on combination of apoptosis and routine biomarkers for accurate evaluation of fibrosis stages in HCV patients. PATIENTS AND METHODS Peripheral blood T lymphocytes were isolated from 72 patients with hepatitis C virus and 25 healthy control individuals. Serum samples were collected at time of liver biopsy. Liver fibrosis was tested in biopsies using the Metavair score system. Stepwise linear discriminate analysis and area under receiver-operating characteristic curves were utilized to produce a predictive score comprising significant apoptosis biomarkers. RESULTS A novel score named apoptosis fibrosis index (AFI) was created on the basis of a combination of CD8/Annexin, albumin and platelets. The multivariate discriminate analysis selected a score based on absolute values of the three biochemical markers; score = 5.8 + 0.008×CD8/Annexin-V (%) - 1.4×Albumin (g/dl) - 0.001×Platelet count (10/L), where 5.8 considered numerical constant. AFI produce an area under the curve of one for significant fibrosis, 0.80 for advanced fibrosis, and 0.889 for cirrhosis. CONCLUSION Apoptosis biomarkers in HCV patients were associated with liver fibrosis. AFI score, a novel noninvasive test, can be used easily for the prediction of liver fibrosis stage and may decrease the need for liver biopsy in hepatitis C virus Egyptian patients.
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A Novel Prediction Model for Significant Liver Fibrosis in Patients with Chronic Hepatitis B. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6839137. [PMID: 32695818 PMCID: PMC7368191 DOI: 10.1155/2020/6839137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/19/2020] [Indexed: 12/07/2022]
Abstract
Background Preventing liver fibrosis from progressing to cirrhosis and even liver cancer is a key step in the treatment of chronic hepatitis B (CHB). This study is aimed at constructing and validating a new nomogram for predicting significant liver fibrosis (S ≥ 2) in CHB patients. Methods The nomogram was based on a retrospective study of 252 CHB patients. The predictive accuracy and discriminative ability of the nomogram were evaluated by the area under receiver operating characteristic curve (AUROC), decision curves, and calibration curve compared with the fibrosis 4 score (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI). The results were validated using bootstrap resampling and an external set of 168 CHB patients. Results A total of 420 CHB patients were enrolled based on liver biopsy results. Independent factors predicting significant liver fibrosis were laminin (LN), procollagen type III N-terminal peptide (PIIINP), and blood platelet count (PLT) in a multivariate analysis, and these factors were selected to construct the nomogram. The calibration curve for the probability of significant liver fibrosis showed optimal agreement between the prediction from the nomogram and actual observation. The prediction from the nomogram was more consistent with the results of liver biopsy than FIB-4 and APRI. The AUROC of the nomogram was higher than that of FIB-4 and APRI for predicting significant liver fibrosis. These results were confirmed in the validation set. Furthermore, the decision curve analysis suggested that the most net benefits were provided by the nomogram. Conclusions We found the proposed nomogram resulted in a more accurate prediction of significant liver fibrosis in CHB patients and could provide the most net benefits. We recommend this noninvasive assessment for patients with liver fibrosis to avoid the risk of liver biopsy and earlier intervention to prevent the development of cirrhosis or liver cancer.
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Komarowska M, Szymańska B, Ołdak Ł, Sankiewicz A, Matuszczak E, Gorodkiewicz E, Debek W, Milewski R, Hermanowicz A. Plasma level of laminin 5 and collagen IV in cryptorchidism. Adv Med Sci 2020; 65:176-181. [PMID: 31978696 DOI: 10.1016/j.advms.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 04/15/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Laminin 5 and collagen IV are the main compounds of the extracellular matrix of the germinal epithelium. The purpose of this study was to evaluate the concentration of these two markers of fibrosis in the plasma of boys with congenital unilateral cryptorchidism. MATERIALS AND METHODS The study group comprised 43 boys aged 1-3 years with congenital unilateral cryptorchidism. The control group included 54 healthy, age matched boys, admitted for planned hernioplasty. To assess laminin 5 and collagen IV in the plasma of boys with unilateral cryptorchidism, we used a new biosensor with Surface Plasmon Resonance Imaging technique detection. RESULTS The median concentration of laminin 5 and collagen IV in the serum of boys with congenital, unilateral cryptorchidism was higher than in boys with normal scrotal testis. The difference was statistically significant (p < 0.0001). We did not notice a correlation between a higher position of the testicles in the inguinal and/or their condition and levels of laminin 5 and collagen IV in the plasma. CONCLUSION Laminin 5 and collagen IV concentrations in the plasma were higher in patients with congenital unilateral cryptorchidism. We believe that in the future, our results could be compared with fertility level in adulthood.
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Affiliation(s)
- Marta Komarowska
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Beata Szymańska
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Łukasz Ołdak
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Anna Sankiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Ewa Matuszczak
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Ewa Gorodkiewicz
- Electrochemistry Department, University of Bialystok, Bialystok, Poland
| | - Wojciech Debek
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland
| | - Robert Milewski
- Department of Statistics and Medical Informatics, Medical University of Bialystok, Bialystok, Poland
| | - Adam Hermanowicz
- Department of Pediatric Surgery and Urology, Medical University of Bialystok, Bialystok, Poland.
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Younesi S, Parsian H. Diagnostic accuracy of glycoproteins in the assessment of liver fibrosis: A comparison between laminin, fibronectin, and hyaluronic acid. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 30:524-531. [PMID: 31144658 DOI: 10.5152/tjg.2019.17339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND/AIMS Liver fibrosis is a chronic liver injury affecting numerous individuals in the world, and efforts have been exercised for introducing a non-invasive method to evaluate the stages of liver fibrosis, which can be used instead of invasive methods, such as a liver biopsy. Various glycoproteins have been suggested by many investigators as indicators of liver fibrosis. This study aimed to compare the diagnostic accuracy of serum laminin, fibronectin, and hyaluronic acid levels in the assessment of liver fibrosis for discriminating patients from healthy subjects. MATERIALS AND METHODS We searched the English language literature to identify relevant studies regarding the role of glycoproteins in the assessment of liver fibrosis, using the following electronic databases: Medline, PubMed central, web of knowledge (ISI), Scopus, Google scholar, Springer, and Science Direct from 1981 to 2016. The key words used for searching were "glycoproteins", "laminin", "hyaluronic acid", "fibronectin", "diagnostic accuracy", "assessment", "liver fibrosis", "cirrhosis", "liver biopsy", "grading", and "staging". The statistical data relevant for the diagnostic accuracy were extracted and analyzed using the summary receiver operating characteristic curves. RESULTS The diagnostic accuracy among the glycoproteins involved in this study were compared, and the area under curves for serum levels of laminin, hyaluronic acid, and fibronectin, as indicators of diagnostic accuracy, were 0.89, 0.82, and 0.73, respectively. CONCLUSION It can be concluded that when liver biopsy is contraindicated, the serum levels of laminin, hyaluronic acid, and fibronectin can be considered screening tests as well as additional clinically useful tools for the evaluation of liver fibrosis.
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Affiliation(s)
- Slimin Younesi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Hadi Parsian
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
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Zhong HJ, Sun HH, Xue LF, McGowan EM, Chen Y. Differential hepatic features presenting in Wilson disease-associated cirrhosis and hepatitis B-associated cirrhosis. World J Gastroenterol 2019; 25:378-387. [PMID: 30686905 PMCID: PMC6343092 DOI: 10.3748/wjg.v25.i3.378] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/03/2019] [Accepted: 01/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cirrhosis is a chronic late stage liver disease associated with hepatitis viruses, alcoholism, and metabolic disorders, such as Wilson disease (WD). There are no clear markers or clinical features that define cirrhosis originating from these disparate origins. We hypothesized that cirrhosis is not one disease and cirrhosis of different etiology may have differential clinical hepatic features. AIM To delineate the liver features between WD-associated cirrhosis and hepatitis B-associated cirrhosis in the Chinese population. METHODS In this observational study, we reviewed the medical data of consecutive inpatients who had WD-associated cirrhosis or hepatitis B-associated cirrhosis from January 2010 to August 2018, and excluded patients who had carcinoma, severe heart or pulmonary diseases, or other liver diseases. According to the etiology of cirrhosis, patients were divided into two groups: WD-associated cirrhosis group (60 patients) and hepatitis B-associated cirrhosis group (56 patients). The liver fibrosis degree, liver function indices, and portal hypertension features of these patients were compared between the two groups. RESULTS No inter-group differences were observed in the diagnostic liver fibrosis markers, however, clinical features clearly defined the origin of cirrhosis. WD-associated cirrhosis patients (16-29 years) had lower levels of alanine transaminase, aspartate transaminase, and bilirubin, lower prothrombin time, lower incidence of hepatic encephalopathy, and lower portal vein diameter (P < 0.05), compared to cirrhosis resulting from hepatitis B in older patients (45-62 years). Importantly, they had decreased risks of progression from Child-Pugh grade A to B (odds ratio = 0.046, 95% confidence interval: 0.006-0.387, P = 0.005) and of ascites (odds ratio = 0.08, 95% confidence interval: 0.01-0.48, P = 0.005). Conversely, WD-associated cirrhosis patients had a higher risk of splenomegaly (odds ratio = 4.15, 95% confidence interval: 1.38-12.45, P = 0.011). CONCLUSION WD-associated cirrhosis presents a higher risk of splenomegaly associated with leukopenia and thrombocytopenia, although revealing milder liver dysfunction and portal hypertension symptoms, which recommends WD patients to be monitored for associated complications.
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Affiliation(s)
- Hao-Jie Zhong
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510000, Guangdong Province, China
- Department of Gastroenterology, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Huan-Huan Sun
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an 710000, Shaanxi Province, China
| | - Lan-Feng Xue
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510000, Guangdong Province, China
| | - Eileen M McGowan
- Faculty of Science, University of Technology Sydney, Sydney NSW 2007, Australia
| | - Yu Chen
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510000, Guangdong Province, China
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Liao Y, Gong J, Zhou W, Dong H, Liang J, Luo M, Hu B. Serum liver fibrosis markers discriminate significant liver inflammation in chronic hepatitis B patients with normal or near-normal alanine aminotransferase. J Med Virol 2018; 91:642-649. [PMID: 30537157 DOI: 10.1002/jmv.25364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/18/2018] [Indexed: 12/30/2022]
Abstract
Chronic liver inflammation caused by chronic hepatitis B virus (CHB) infection leads to liver cirrhosis and hepatocellular carcinoma. Recently, the role of alanine aminotransferase (ALT) as a predictor of liver inflammation has been questioned. The aim of this study was to investigate the utility of noninvasive fibrosis markers including hyaluronic acid (HA), collagen type IV (CIV), N-terminal propeptide of type III procollagen (PIIINP), and laminin (LN) in identifying significant liver inflammation in patients with CHB, especially in patients with normal or near-normal ALT. A total of 242 CHB patients who underwent liver biopsy were enrolled. The serum levels of ALT, aspartate aminotransferase, HA, CIV, PIIINP, and LN were quantified and the relationship between histological staging and serum markers was systematically analyzed. Serum CIV, PIIINP, HA, and LN levels increased significantly along with the increasing severity of liver inflammation. Multivariate analysis showed that CIV and LN were independently associated with significant inflammation. CIV, PIIINP, HA, and LN levels were found to have high diagnostic values for predicting significant inflammation in patients with CHB (area under the curve, AUC = 0.807, 0.795, 0.767, and 0.703, respectively). The combined index for the identification of significant inflammation, including CIV, PIIINP, HA, and LN levels, significantly improved diagnostic performance (AUC = 0.851). Moreover, the combined index also achieved excellent diagnostic accuracy (AUC = 0.861) in patients with CHB with normal or near-normal ALT. In conclusion, the combined index may be a strong indicator for discriminating significant liver inflammation, especially in patients with CHB with normal or near-normal ALT.
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Affiliation(s)
- Yuan Liao
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jiao Gong
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wenying Zhou
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huimin Dong
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jiayin Liang
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Minqi Luo
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Bo Hu
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Nie JM, Li HF. Therapeutic effects of Salvia miltiorrhiza injection combined with telmisartan in patients with diabetic nephropathy by influencing collagen IV and fibronectin: A case-control study. Exp Ther Med 2018; 16:3405-3412. [PMID: 30233688 PMCID: PMC6143830 DOI: 10.3892/etm.2018.6654] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/01/2018] [Indexed: 01/11/2023] Open
Abstract
Involvement of collagen IV (ColIV) and fibronectin (FN) in the occurrence and development of diabetic nephropathy (DN) and the effects of telmisartan and Salvia miltiorrhiza injection in the treatment of the patients were investigated. Two hundred and fifty-eight patients with stage IV DN were selected as the case group, and another 110 normal healthy subjects were incorporated as the control group. Involved patients were subdivided into different groups according to different treatment therapies; patients in the telmisartan group (T group) were given oral telmisartan; patients in the Salvia miltiorrhiza injection + telmisartan (S + T group) were administered with Salvia miltiorrhiza injection combined with telmisartan treatment, and there was a group of patients who received no intervention as the placebo group. After intervention, levels of glycemic indexes and renal damage indexes indicated downwards trends both in the T group and the S + T group when compared to the placebo group; besides, levels in the S + T group were much lower than those in the T group (all P<0.05). Additionally, in comparison among the above three intervention groups, differences in the fasting blood glucose, 2 h post-prandial blood glucose, glycosylated hemoglobin, blood urea nitrogen, serum creatinine and urinary albumin excretion rate were significant after treatment (all P<0.05). Further, before intervention, both Co1IV and FN in the urine were increased in the case group compared to the control group (all P<0.05). After intervention, both levels were apparently decreased. There were remarkable differences of Co1IV and FN levels in the urine when compared among three different intervention groups after treatment (P<0.05). Increased ColIV and FN levels may be partially responsible for the development of DN. Salvia miltiorrhiza injection with telmisartan have beneficial synergistic effects for DN patients through attenuating the increase in ColIV and FN, reversing hyperglycemia state and postponing ultrastructure changes of glomerular basement membrane.
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Affiliation(s)
- Jie-Ming Nie
- Department of Internal Medicine, Τhe Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Hai-Feng Li
- Department of Pharmaceutical Analysis, ALK-Abello A/S Guangzhou Office, Guangzhou, Guangdong 510620, P.R. China
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Interaction of hepatic stellate cells with neutrophils and macrophages in the liver following oncogenic kras activation in transgenic zebrafish. Sci Rep 2018; 8:8495. [PMID: 29855567 PMCID: PMC5981472 DOI: 10.1038/s41598-018-26612-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/03/2018] [Indexed: 12/15/2022] Open
Abstract
Activation of hepatic stellate cells (HSC) plays a crucial role in the liver disease progression from liver fibrosis/cirrhosis to cancer. Here, we found a rapid change of microenvironment after krasV12-induction in zebrafish liver with progressively increased stromal cell number and enlarged liver size. Neutrophils and macrophages exhibited a faster response than HSCs. By manipulating the numbers of neutrophils and macrophages through morpholino knockdown, we found that macrophages contributed to both HSC survival and activation while neutrophils appear to be only required for HSC activation. Serotonin, which is essential for HSC survival and activation, was found up-regulated in hepatocytes and macrophages, but not in neutrophils after krasV12 induction. Serotonin receptor was highly expressed in HSCs; increase of the receptor activity by an agonist stimulated HSCs and oncogenic growth of the liver while an opposite effect was observed with an antagonist. Activated HSCs promoted the pro-tumorigenesis functions of neutrophils and macrophages through secretion of Tgfb1. Overall, these observations elucidated a cellular interaction in microenvironment where that upregulated serotonin in hepatocytes and macrophages activated HSCs. Since the microenvironment crosstalk plays a vital role in manipulation of liver carcinogenesis, the underlying mechanism may provide potential therapeutic targets for liver diseases.
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Dong H, Xu C, Zhou W, Liao Y, Cao J, Li Z, Hu B. The combination of 5 serum markers compared to FibroScan to predict significant liver fibrosis in patients with chronic hepatitis B virus. Clin Chim Acta 2018; 483:145-150. [PMID: 29709450 DOI: 10.1016/j.cca.2018.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND We evaluated the performance of serum hyaluronan (HA), procollagen type III N-terminal peptide (PIIINP), type IV collagen (IVC), laminin (LN), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), compared to transient elastography (FibroScan) in predicting significant liver fibrosis. METHODS We therefore determined 4 serum fibrosis markers, FibroScan and liver biopsy in 70 consecutive adult patients with chronic hepatitis B. According to a modified Scheuer scoring system, significant fibrosis was defined as fibrosis stage ≥S2. We compared serum fibrosis markers to histological staging and FibroScan results using Spearman correlation analysis and area under receiver operating characteristic (ROC) curves (AUROCs). RESULTS Of the 212 patients who had the results of FibroScans and four serum fibrosis markers for HBV, 70 had concurrent liver biopsy. Significant liver fibrosis was found in 24/70 patients. The serum levels of HA, PIIINP, IVC, LN, ALT, AST was all positively correlated with fibrosis stage of Liver biopsy. The coefficients with stages were respectively 0.468, 0.392, 0.538, 0.213, 0.350, 0.375. There was a significant difference between mild fibrosis (<S2) and significant fibrosis (≥S2), excluding LN, in the levels of these 5 serum makers (P < .05). AUROC for FibroScans and HA, PIIINP, IVC, LN, ALT, AST to correctly allocate patients to histological fibrosis stage ≥ S2 was 0.866, 0.784, 0.738, 0.827, 0.630, 0.713 and 0.728 respectively. Since LN shows the worst performance of the others. We decided to check the performance of the combination of HA, PIIINP, CIV, ALT, AST, excluding LN, to distinguish fibrosis stages. The index of the histological fibrosis stage ≥ S2, combining the 5 serum markers, significantly improved diagnostic performance (AUROC = 0.861) compared to the use of 5 serum markers alone in all HBV patients. CONCLUSION The combination of the 5 serum markers and FibroScan performed equally well in predicting significant fibrosis. The combination of the 5 serum markers is a reliable noninvasive method to predict significant liver fibrosis in patients with CHB. So, it provide another choice rather than FibroScan in predicting significant liver fibrosis.
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Affiliation(s)
- Huimin Dong
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China
| | - Changzhi Xu
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China
| | - Wenying Zhou
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China
| | - Yuan Liao
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China
| | - Junyan Cao
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China
| | - Zhaoxia Li
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China.
| | - Bo Hu
- Department of Laboratory Medicine, Third Affiliated Hospital, Sun Yat-sen University, PR China.
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Li L, Niu C, Li T, Wan Y, Zhou Y, Wang H, Yuan R, Liao P. Ultrasensitive electrochemiluminescence biosensor for detection of laminin based on DNA dendrimer-carried luminophore and DNA nanomachine-mediated target recycling amplification. Biosens Bioelectron 2018; 101:206-212. [DOI: 10.1016/j.bios.2017.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/24/2017] [Accepted: 10/02/2017] [Indexed: 12/16/2022]
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Tang N, Zhang Y, Liang Q, Liu Z, Shi Y. The role of ursodeoxycholic acid on cholestatic hepatic fibrosis in infant rats. Mol Med Rep 2017; 17:3837-3844. [PMID: 29257337 DOI: 10.3892/mmr.2017.8284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/08/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to identify the impact of ursodeoxycholic acid (UDCA) on liver function and fibrosis markers in infant rats by establishing a cholestatic‑induced hepatic fibrosis model. α‑naphthylisothiocyanate (ANIT) was administrated by gavage to induce cholestatic hepatic fibrosis in infant rats. UCDA treatment was performed to assess its impact on biochemical indicators of liver function, four serum biomarkers of hepatic fibrosis, hepatic fibrosis indices in liver tissues and the pathology of liver tissues. Colorimetric assays and biochemical assays based on the initial rate method were performed to determine the levels of liver function markers in the serum, whereas the serum biomarkers of hepatic fibrosis were measured via radioimmunoassay. Sections of liver tissue were harvested and stained with hematoxylin‑eosin or picric acid‑Sirius red, and subjected to immunohistochemical staining to analyze liver pathology. All indicators of liver function, except for cholinesterase, were significantly higher in the ANIT model than in the control group (P<0.01). γ‑glutamyl transpeptidase and total bile acids of the UDCA treatment group were significantly lower than the ANIT model (P<0.05); whereas no significant differences were observed in alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin and indirect bilirubin between the two groups. Serum laminin protein (LN) and type‑IV collagen (cIV) in the UDCA treatment group were significantly lower than in the ANIT model (P<0.01); whereas no significant differences were observed in hyaluronic acid and type‑III procollagen between the two groups. Liver LN and cIV in the UDCA treatment group were significantly lower than in the ANIT model (P<0.01). The degree of hepatic fibrosis in the UDCA treatment group was significantly lower than in the ANIT model (P<0.01). The results of the present study demonstrated that UDCA is able to reduce LN and cIV in serum and protect liver tissues against hepatic fibrosis.
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Affiliation(s)
- Ning Tang
- Department of Pediatrics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Yaping Zhang
- Department of Pediatrics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Qinghong Liang
- Department of Pediatrics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Zeyu Liu
- Department of Pediatrics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Yingping Shi
- Department of Pathology, Tianjin Nankai Hospital, Tianjin 300100, P.R. China
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Su Y, Gu H, Weng D, Zhou Y, Li Q, Zhang F, Zhang Y, Shen L, Hu Y, Li H. Association of serum levels of laminin, type IV collagen, procollagen III N-terminal peptide, and hyaluronic acid with the progression of interstitial lung disease. Medicine (Baltimore) 2017; 96:e6617. [PMID: 28471958 PMCID: PMC5419904 DOI: 10.1097/md.0000000000006617] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Noninvasive and convenient tests to assess pulmonary fibrosis and disease progression in interstitial lung diseases (ILDs) are currently unavailable. The extracellular matrix molecules, laminin (LN), type IV collagen (IVC), procollagen III N-terminal peptide (PIIINP), and hyaluronic acid (HA) are involved in ILD development and progression. This study aims to investigate the association of disease progression and serum levels of LN, IVC, PIIINP, and HA in patients with ILD. This retrospective study included 323 patients (162 cases of idiopathic pulmonary fibrosis [IPF] and 161 cases of connective tissue diseases ILD [CTD-ILD]) treated in Shanghai Pulmonary Hospital between January 2013 and January 2015 and 160 healthy controls. Serum LN, IVC, PIIINP, and HA were analyzed by radioimmunoassay. Data of the percentage of forced vital capacity in the prediction value (FVC%pred), the percentage of diffusing capacity of the lung for carbon monoxide in the prediction value (DLCO%pred), high resolution computed tomography (HRCT) score, and patient mortality were collected. Serum LN, IVC, PIIINP, and HA were significantly increased in the patients with IPF or CTD-ILD compared with the healthy controls (all P < .05) and were further elevated in the acute exacerbation cases (all P < .05). Serum LN, IVC, PIIINP, and HA positively correlated with HRCT score and negatively correlated with FVC%pred and DLCO%pred significantly in the patients (all P < .05). The survived patients had significantly lower serum LN, IVC, PIIINP, and HA than the dead patients (all P < .05). Serum levels of LN, IVC, PIIINP, and HA may reflect ILD progression and may be indicators for the severity of ILDs.
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Affiliation(s)
- Yiliang Su
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Hongyan Gu
- Department of Respiratory Medicine, Nantong Sixth People's Hospital, Nantong, China
| | - Dong Weng
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Ying Zhou
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Qiuhong Li
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Fen Zhang
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Yuan Zhang
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Li Shen
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Yang Hu
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
| | - Huiping Li
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai
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24
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Qi X, Liu X, Zhang Y, Hou Y, Ren L, Wu C, Chen J, Xia C, Zhao J, Wang D, Zhang Y, Zhang X, Lin H, Wang H, Wang J, Cui Z, Li X, Deng H, Hou F, Peng Y, Wang X, Shao X, Li H, Guo X. Serum Liver Fibrosis Markers in the Prognosis of Liver Cirrhosis: A Prospective Observational Study. Med Sci Monit 2016; 22:2720-30. [PMID: 27480906 PMCID: PMC4973794 DOI: 10.12659/msm.900441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The prognostic role of serum liver fibrosis markers in cirrhotic patients remains unclear. We performed a prospective observational study to evaluate the effect of amino-terminal pro-peptide of type III pro-collagen (PIIINP), collagen IV (CIV), laminin (LN), and hyaluronic acid (HA) on the prognosis of liver cirrhosis. MATERIAL AND METHODS All patients who were diagnosed with liver cirrhosis and admitted to our department were prospectively enrolled. PIIINP, CIV, LN, and HA levels were tested. RESULTS Overall, 108 cirrhotic patients were included. Correlation analysis demonstrated that CIV (coefficient r: 0.658, p<0.001; coefficient r: 0.368, p<0.001), LN (coefficient r: 0.450, p<0.001; coefficient r: 0.343, p<0.001), and HA (coefficient r: 0.325, p=0.001; coefficient r: 0.282, p=0.004) levels, but not PIIINP level (coefficient r: 0.081, p=0.414; coefficient r: 0.090, p=0.363), significantly correlated with Child-Pugh and MELD scores. Logistic regression analysis demonstrated that HA (odds ratio=1.00003, 95% confidence interval [CI]=1.000004-1.000056, p=0.022) was significantly associated with the 6-month mortality. Receiver operating characteristics analysis demonstrated that the area under the curve (AUC) of HA for predicting the 6-month mortality was 0.612 (95%CI=0.508-0.709, p=0.1531). CONCLUSIONS CIV, LN, and HA levels were significantly associated with the severity of liver dysfunction, but might be inappropriate for the prognostic assessment of liver cirrhosis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xiaozhong Guo
- Corresponding Authors: Xiaozhong Guo, e-mail: , Xingshun Qi, e-mail:
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Jiang X, Wang H, Wang H, Zhuo Y, Yuan R, Chai Y. Self-enhanced N-(aminobutyl)-N-(ethylisoluminol) derivative-based electrochemiluminescence immunosensor for sensitive laminin detection using PdIr cubes as a mimic peroxidase. NANOSCALE 2016; 8:8017-8023. [PMID: 27010575 DOI: 10.1039/c6nr00229c] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Herein, a self-enhanced N-(aminobutyl)-N-(ethylisoluminol) (ABEI) derivative-based electrochemiluminescence (ECL) immunosensor was constructed for the determination of laminin (LN) using PdIr cubes as a mimic peroxidase for signal amplification. Initially, PdIr cubes with efficient peroxidase mimicking properties, large specific surface areas, and good stability and uniformity were synthesized. Then, L-cysteine (L-Cys) and ABEI were immobilized on the PdIr cubes to form the self-enhanced ECL nanocomplex (PdIr-L-Cys-ABEI). In this nanocomplex, PdIr cubes, whose catalytic constant is higher than that of horseradish peroxidase (HRP), could effectively catalyze H2O2 decomposition and thus enhance the ECL intensity of ABEI. Moreover, PdIr cubes can be easily modified with functional groups, which make them adaptable to desired supported platforms. On the other hand, L-Cys as a coreactant of ABEI could effectively enhance the luminous efficiency due to the intramolecular ECL reaction which could reduce the energy loss between L-Cys and ABEI by giving a shorter electron transfer distance. The developed strategy combined an ABEI derivative as a self-enhanced ECL luminophore and PdIr cubes as a mimic peroxidase, resulting in a significantly enhanced ECL signal output. Also, the strategy showed high sensitivity and selectivity for LN, which suggested that our new approach could be potentially applied in monitoring different proteins.
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Affiliation(s)
- Xinya Jiang
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
| | - Huijun Wang
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
| | - Haijun Wang
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
| | - Ying Zhuo
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
| | - Ruo Yuan
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
| | - Yaqin Chai
- Key Laboratory of Luminescent and Real-Time Analytical Chemistry (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing 400715, People's Republic of China.
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Amarapurkar D, Amarapurkar A. Indications of Liver Biopsy in the Era of Noninvasive Assessment of Liver Fibrosis. J Clin Exp Hepatol 2015; 5:314-9. [PMID: 26900273 PMCID: PMC4723644 DOI: 10.1016/j.jceh.2015.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 08/24/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Liver biopsy (LB) has been used as diagnostic modality in liver diseases (LD). Over last two decades, there has been remarkable improvement in understanding of natural history, molecular diagnostics of viral hepatitis, genetic of LD, and also limitations of LB. There is current trend in avoiding LB in the management of various LDs. AIM To determine utility of LB in clinical practice. MATERIAL AND METHODS In a prospective study, 2413 patients of LD were followed up, 219 (9%) were acute, and remaining 2194 (90.9%) were chronic LD. Patients were evaluated by biochemical parameters, virological studies, and imaging endoscopy as and when required. LB was performed in 176 (7.2%) patients when no conclusion could be drawn from the noninvasive workup. Patients with platelet count <50,000/cm(2), ascites, and overt bleeding were excluded. Patients with international normalization ratio (INR) more than 1.5 were not excluded. No prophylactic use of fresh frozen plasma and platelet transfusion was done. There was no major complication related to the procedure. Indications for LB were as follows: cryptogenic LD 38 cases, hepatitis B infection 35, suspected autoimmune hepatitis 30, mass lesion in the liver and lymphoma 29, evaluation of portal hypertension 15, elevated liver enzymes 11, hepatitis C infection 9, and drug-induced LD 4, and miscellaneous 5 cases which were primary biliary cholangitis, primary sclerosing cholangitis, cholestatic LD, sarcoidosis, and amyloidosis. RESULTS LB changed the diagnosis in 55 (31.2%). These were cryptogenic LD in 24 cases, portal hypertension 15, elevated liver enzymes 11, and 5 others. In remaining, LB confirmed clinical diagnosis and helped in making management decisions. CONCLUSION LB was required in 7.2% of patients with chronic LD. In 31.2% cases, LB changed the diagnosis. LB was a safe procedure even in presence of low platelet count and abnormal INR.
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Key Words
- AIH, autoimmune hepatitis
- APRI, aspartate transaminases to platelet ratio index
- CMV, cytomegalovirus
- EBV, Epstein bar virus
- HCC, hepatocellular carcinoma
- HEV, hepatitis E virus
- INCPH, idiopathic noncirrhotic portal hypertension
- LB, liver biopsy
- LD, liver disease
- NAFLD, nonalcoholic fatty liver disease
- NASH, nonalcoholic steatohepatitis
- NRH, nodular regenerative hyperplasia
- autoimmune hepatitis
- cryptogenic cirrhosis
- noncirrhotic portal hypertension
- steatohepatitis
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Shen Y, Shi G, Huang C, Zhu X, Chen S, Sun H, Zhou J, Fan J. Prediction of Post-Operative Liver Dysfunction by Serum Markers of Liver Fibrosis in Hepatocellular Carcinoma. PLoS One 2015; 10:e0140932. [PMID: 26501145 PMCID: PMC4621018 DOI: 10.1371/journal.pone.0140932] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/01/2015] [Indexed: 12/17/2022] Open
Abstract
Aim To investigate the role of biomarkers in predicting postoperative liver dysfunction in patients with hepatocellular carcinoma (HCC). Methods A total of 200 patients operated from July 2009 to June 2010 at Zhongshan Hospital, Fudan University for pathologically confirmed HCC were retrospectively analyzed for clinical data, HBD DNA level and serum biochemical markers for liver fibrosis. The patients were followed up to observersation end point. Correlation of the monitored parameters with postoperative liver dysfunction and patient survival was statistically analyzed. Results Preoperative hepatitis B virus (HBV) DNA level, serum prealbumin (PA) hyaluronic acid (HA), and laminin (LN) levels correlated with postoperative liver dysfunction. A predictive model was generated using these 4 parameters and validated in 89 HCC patients with sensitivity and specificity of 0.625 and 0.912, respectively. However, no correlation was identified between postoperative liver function and overall survival. Conclusion Liver fibrosis markers could be preoperatively used in predicting postoperative liver dysfunction in HCC patients.
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Affiliation(s)
- Yinghao Shen
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Guoming Shi
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Cheng Huang
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Xiaodong Zhu
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Si Chen
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Huichuan Sun
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
- * E-mail:
| | - Jian Zhou
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Jia Fan
- Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, 180 Fenglin Road, Shanghai, China
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