Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2024; 16(2): 251-263
Published online Feb 27, 2024. doi: 10.4254/wjh.v16.i2.251
Evaluation of G3BP1 in the prognosis of acute and acute-on-chronic liver failure after the treatment of artificial liver support system
Wen-Yuan Li, Lu-Wen Wang, Jin Dong, Yao Wang
Wen-Yuan Li, Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Lu-Wen Wang, Yao Wang, Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Jin Dong, Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Author contributions: Wang Y take responsibility for the integrity of the work as a whole, from inception to published article; Li WY, Wang LW, Dong J and Wang Y conceived and designed the study; Li WY and Wang LW collected and analyzed the data; Li WY and Wang LW wrote the paper; Wang Y edited the article; Li WY and Wang LW contributed equally to this article; All authors approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82100630 and No. 82100894; and the Beijing iGandan Foundation, No. iGandanF-1082022-RGG031.
Institutional review board statement: This study was approved by the Institutional Ethics Committee of Renmin Hospital of Wuhan University, No. 2022K-K215(C01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: All datasets generated for this study are included in the article.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yao Wang, Doctor, Chief Physician, Department of Infectious Diseases, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan 430060, Hubei Province, China. rm003743@whu.edu.cn
Received: November 11, 2023
Peer-review started: November 11, 2023
First decision: December 14, 2023
Revised: December 24, 2023
Accepted: January 15, 2024
Article in press: January 15, 2024
Published online: February 27, 2024
Processing time: 107 Days and 21.8 Hours
Abstract
BACKGROUND

The increased expression of G3BP1 was positively correlated with the prognosis of liver failure.

AIM

To investigate the effect of G3BP1 on the prognosis of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) after the treatment of artificial liver support system (ALSS).

METHODS

A total of 244 patients with ALF and ACLF were enrolled in this study. The levels of G3BP1 on admission and at discharge were detected. The validation set of 514 patients was collected to verify the predicted effect of G3BP1 and the viability of prognosis.

RESULTS

This study was shown that lactate dehydrogenase (LDH), alpha-fetoprotein (AFP) and prothrombin time were closely related to the prognosis of patients. After the ALSS treatment, the patient’ amount of decreased G3BP1 index in difference of G3BP1 between the value of discharge and admission (difG3BP1) < 0 group had a nearly 10-fold increased risk of progression compared with the amount of increased G3BP1 index. The subgroup analysis showed that the difG3BP1 < 0 group had a higher risk of progression, regardless of model for end-stage liver disease high-risk or low-risk group. At the same time, compared with the inflammatory marks [tumor necrosis factor-α, interleukin (IL)-1β and IL-18], G3BP1 had higher discrimination and was more stable in the model analysis and validation set. When combined with AFP and LDH, concordance index was respectively 0.84 and 0.8 in training and validation cohorts.

CONCLUSION

This study indicated that G3BP1 could predict the prognosis of ALF or ACLF patients treated with ALSS. The combination of G3BP1, AFP and LDH could accurately evaluate the disease condition and predict the clinical endpoint of patients.

Keywords: G3BP1; Prognosis; Acute liver failure; Acute-on-chronic liver failure; Artificial liver support system

Core Tip: This study retrospectively analyzed the clinical characteristics and laboratory indicators of acute liver failure and acute-on-chronic liver failure patients treated with artificial liver support system (ALSS). It was found that G3BP1, alpha-fetoprotein, lactate dehydrogenase, tumor necrosis factor-α, and interleukin-1β were independent risk factors. G3BP1 could effectively predict liver failure, which has great value to timely provide liver transplantation opportunity for patients who have failed for drug and ALSS treatment.