Case Control Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2018; 24(12): 1312-1320
Published online Mar 28, 2018. doi: 10.3748/wjg.v24.i12.1312
Serum interleukin-34 level can be an indicator of liver fibrosis in patients with chronic hepatitis B virus infection
Yin-Qiu Wang, Wen-Jun Cao, Yu-Feng Gao, Jun Ye, Gui-Zhou Zou
Yin-Qiu Wang, Wen-Jun Cao, Yu-Feng Gao, Jun Ye, Gui-Zhou Zou, Department of Infectious Disease, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
Author contributions: Wang YQ and Cao WJ contributed to the literature search and writing of the manuscript; Ye J, Zou GZ and Gao YF contributed to the original idea, as well as the polishing and final proof of the manuscript.
Supported by Natural Science Foundation of Anhui Province, No. 1608085MH164.
Institutional review board statement: This study was reviewed and approved by the Biomedical Ethics Committee of the Anhui Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at aygyf@126.com. Participants gave informed consent for data sharing.
STROBE statement: The guidelines of the STROBE Statement have been adopted.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yu-Feng Gao, MAMS, Professor, Department of Infectious Disease, Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Economic and Technological Development District, Hefei 230601, Anhui Province, China. aygyf@126.com
Telephone: +86-551-63869420 Fax: +86-551-63869400
Received: January 21, 2018
Peer-review started: January 22, 2018
First decision: February 3, 2018
Revised: February 11, 2018
Accepted: February 26, 2018
Article in press: February 26, 2018
Published online: March 28, 2018
Processing time: 64 Days and 2.6 Hours
Abstract
AIM

To investigate whether serum interleukin (IL)-34 levels are correlated with hepatic inflammation and fibrosis in patients with chronic hepatitis B virus (HBV) infection.

METHODS

In this study, serum IL-34 levels were assessed by enzyme-linked immunosorbent assay in 19 healthy controls and 175 patients with chronic HBV infection undergoing biopsy. The frequently used serological markers of liver fibrosis were based on laboratory indexes measured at the Clinical Laboratory of the Second Affiliated Hospital of Anhui Medical University. Liver stiffness was detected by transient elastography with FibroTouch. The relationships of non-invasive makers of liver fibrosis and IL-34 levels with inflammation and fibrosis were analyzed. The diagnostic value of IL-34 and other liver fibrosis makers were evaluated using areas under the receiver operating characteristic curves, sensitivity and specificity.

RESULTS

Serum IL-34 levels were associated with inflammatory activity in the liver, and IL-34 levels differed among phases of chronic HBV infection (P = 0.001). By comparing serum IL-34 levels among patients with various stages of liver fibrosis determined by liver biopsy, we found that IL-34 levels ≥ 15.83 pg/mL had a high sensitivity of 86.6% and a specificity of 78.7% for identifying severe fibrosis (S3-S4). Furthermore, we showed that IL-34 is superior to the fibrosis-4 score, one of the serum makers of liver fibrosis, in identifying severe liver fibrosis and early cirrhosis in patients with HBV-related liver fibrosis in China.

CONCLUSION

Our results indicate that IL-34, a cytokine involved in the induction of activation of profibrogenic macrophages, can be an indicator of liver inflammation and fibrosis in patients with chronic HBV infection.

Keywords: Interleukin 34; Hepatitis B virus; Liver fibrosis; Diagnosis

Core tip: Interleukin (IL)-34 is a cytokine involved in the induction of activation of profibrogenic macrophages, which is associated with the severity of liver fibrosis and inflammation. Numerous studies have shown that it has the potential to be a serological indicator of liver fibrosis and inflammation. We investigated the serum IL-34 levels in patients with chronic hepatitis B virus infection, and found the significance of serum levels of IL-34 as a serum target of liver fibrosis associated with chronic hepatitis B virus infection.