Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Feb 7, 2010; 16(5): 625-630
Published online Feb 7, 2010. doi: 10.3748/wjg.v16.i5.625
Serum thymosin β4 levels in patients with hepatitis B virus-related liver failure
Tao Han, Ying Liu, Huan Liu, Zheng-Yan Zhu, Yan Li, Shi-Xiang Xiao, Zhen Guo, Zhen-Gang Zhao
Tao Han, Ying Liu, Huan Liu, Zheng-Yan Zhu, Yan Li, Shi-Xiang Xiao, Zhen Guo, Zhen-Gang Zhao, Department of Hepatology, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cells, Tianjin Third Central Hospital, Tianjin Medical University, 83 Jintang Road, Tianjin 300170, China
Author contributions: Han T designed the study and wrote the paper; Liu Y carried out the laboratory work and wrote the paper; Liu H assisted in the analysis of data; Zhu ZY assisted in the experiment; Li Y, Xiao SX, Guo Z and Zhao ZG collected the blood samples and clinical data.
Supported by The National Basic Research Program of China, No. 2007CB512801; the National 11th 5-year Plan for Hepatitis Research, No. 2008ZX10002-005 and Tianjin Public Health Bureau Key Research Program, No. 07KG9
Correspondence to: Tao Han, MD, PhD, Professor, Department of Hepatology, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cells, Tianjin Third Central Hospital, Tianjin Medical University, 83 Jintang Road, Tianjin 300170, China. hantaomd@126.com
Telephone: +86-22-84112298 Fax: +86-22-84112208
Received: November 1, 2009
Revised: November 30, 2009
Accepted: December 7, 2009
Published online: February 7, 2010
Abstract

AIM: To investigate whether serum thymosin β4 can provide diagnostic or prognostic information in liver failure patients caused by chronic hepatitis B virus (HBV) infection.

METHODS: Serum thymosin β4 levels were measured in 30 patients with acute-on-chronic liver failure (ACLF), 31 patients with chronic liver failure (CLF), 30 patients with compensated liver cirrhosis (CR) and 32 patients with chronic hepatitis B and 30 healthy controls. Serum thymosin β4 levels were measured by enzyme-linked immunosorbent assay and Child-Pugh and model for end-stage liver disease (MELD) scores were calculated for each patient on admission.

RESULTS: Compared with healthy controls, serum thymosin β4 levels in ACLF, CLF, CR and chronic hepatitis B patients were significantly lower, 6.5047 (4.7879-10.5314) μg/mL vs 0.4632 (0.2759-0.8768) μg/mL, 0.6981 (0.5209-1.2008) μg/mL, 1.8053 (0.8110-2.3397) μg/mL, 3.7803 (1.8570-6.4722) μg/mL, respectively (P < 0.001). The levels of thymosin β4 in liver failure (ACLF or CLF) patients were markedly lower than that in CR (P < 0.001), and a difference was also found between CLF and ACLF patients (P = 0.038). In patients with chronic liver disease, there was a positive relationship between thymosin β4 levels and albumin, choline esterase, and platelet (P < 0.001), and negative relationship with alanine aminotransferase (P = 0.020), aspartate aminotransferase, total bilirubin, international normalized ratio of prothrombin time, and Child-Pugh and MELD scores (P < 0.001). Of the 61 liver failure patients, the thymosin β4 levels of non-survivors were significantly lower than that of survivors (P = 0.007). Receiver operating characteristics analysis identified a thymosin β4 cutoff level of 0.5708 μg/mL for predicting poor prognosis in all liver failure patients. The serial thymosin β4 values were observed in 13 liver failure inpatients. Lower initial values were observed in the death. While greater improvement in thymosin β4 value was found in those who recovered from the disease.

CONCLUSION: Serum thymosin β4 can be used as an important potential predictor for liver failure caused by chronic HBV infection.

Keywords: Thymosin β4; Liver failure; Serum; Hepatitis B virus; Biochemistry