scholarly journals Increased Serum Soluble Urokinase Plasminogen Activator Receptor Predicts Short-Term Outcome in Patients with Hepatitis B-Related Acute-on-Chronic Liver Failure

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Zuxiong Huang ◽  
Ning Wang ◽  
Shuiwen Huang ◽  
Yi Chen ◽  
Shida Yang ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Liver Failure ◽  
Predictive Value ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Urokinase Plasminogen Activator Receptor ◽  
Term Outcome ◽  
Supar Level ◽  
Short Term Outcome ◽  
Plasminogen Activator Receptor

Aims. Soluble urokinase plasminogen activator receptor (suPAR) reflects the immune activation in circumstances of inflammation and infection. It has been considered as a risk biomarker associated with poor outcome in various low-grade inflammation and infectious diseases. The study is aimed at investigating whether suPAR has a predictive value with short-term survival in patients with hepatitis B-related acute-on-chronic liver failure (HB-ACLF). Methods. Serum suPAR expression was compared among patients with different states of chronic hepatitis B virus infection. Sixty HB-ACLF patients were recruited as the training cohort and followed up for 90 days. Serum suPAR level and the clinical relevance with short-term outcome were investigated. The temporal dynamics of suPAR were evaluated in 50 HB-ACLF patients with available serum sequentially at baseline, week 2 and week 4. Another 167 HB-ACLF patients were enrolled to validate the predictive value of suPAR with respect to the prognosis. Results. Serum suPAR level was significantly increased in HB-ACLF patients compared to non-ACLF patients. In the training set of HB-ACLF, we observed higher suPAR level, INR, MELD score, and more complications in nonsurvivors than survivors. Longitudinal analysis revealed an increased trend of suPAR level in nonsurvivors during week 0 to week 4 and the modest decline in survivors. It showed that the synchronous suPAR level was higher in nonsurvivors at all indicated time points. Elevated suPAR level at baseline was identified as a strong predictor of a 90-day mortality of HB-ACLF patients. It was confirmed suPAR>16.26 ng/ml had a positive predictive value of 72.22% and a negative predictive value of 77.88% for poor outcome in the validation cohort. Conclusions. Serum suPAR level increases significantly in HB-ACLF patients and associated with a 90-day mortality. It suggests that suPAR might be a potential biomarker to predict the prognosis of HB-ACLF patients.

scholarly journals Characteristics of infection and its impact on short-term outcome in patients with acute-on-chronic liver failure

Medicine ◽  
2017 ◽  
Vol 96 (37) ◽  
pp. e8057 ◽  
Author(s):  
Junjun Cai ◽  
Mengchen Zhang ◽  
Tao Han ◽  
Hui-qing Jiang
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

scholarly journals Soluble urokinase plasminogen activator receptor is associated with short-term mortality and enhanced reactive oxygen species production in acute-on-chronic liver failure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunyun Wang ◽  
Fengtian Wu ◽  
Chao Chen ◽  
Lichen Xu ◽  
Wei Lin ◽  
...  
Keyword(s):  
Reactive Oxygen Species ◽  
Liver Failure ◽  
Chronic Liver ◽  
Ros Production ◽  
Oxygen Species ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Urokinase Plasminogen Activator Receptor ◽  
Short Term Mortality ◽  
Plasminogen Activator Receptor

Abstract Background Acute-on-chronic liver failure (ACLF) is a comprehensive syndrome characterized by an acute deterioration of liver function and high short-term mortality rates in patients with chronic liver disease. Whether plasma soluble urokinase plasminogen activator receptor (suPAR) is a suitable biomarker for the prognosis of patients with ACLF remains unknown. Method A prospective cohort of 282 patients with ACLF from three hospitals in China was included. 88.4% of the group was hepatitis B virus-related ACLF (HBV-related ACLF). Cox regression was used to assess the impact of plasma suPAR and other factors on 30- and 90-day mortality. Reactive oxygen species (ROS) production were detected to explore the role of suPAR in regulating neutrophil function in HBV-related ACLF. Result There was no difference in plasma suPAR levels between HBV-related and non-HBV-related ACLF. Patients with clinical complications had higher suPAR levels than those without these complications. A significant correlation was also found between suPAR and prognostic scores, infection indicators and inflammatory cytokines. Cox’s regression multivariate analysis identified suPAR ≥ 14.7 ng/mL as a predictor for both day 30 and 90 mortality (Area under the ROC curve: 0.751 and 0.742 respectively), independent of the MELD and SOFA scores in patients with ACLF. Moreover, we firstly discovered suPAR enhanced neutrophil ROS production under E.coli stimulation in patients with HBV-related ACLF. Conclusions suPAR was a useful independent biomarker of short-term outcomes in patients with ACLF and might play a key role in the pathogenesis. Trial registration CNT, NCT02965560.

Soluble Urokinase Plasminogen Activator Receptor is Associated with Short-Term Mortality and Enhanced Reactive Oxygen Species Production in Acute-on-Chronic Liver Failure

2020 ◽  
Author(s):  
Yunyun Wang ◽  
Fengtian Wu ◽  
Chao Chen ◽  
Lichen Xu ◽  
Wei Lin ◽  
...  
Keyword(s):  
Reactive Oxygen Species ◽  
Liver Failure ◽  
Chronic Liver ◽  
Ros Production ◽  
Oxygen Species ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Urokinase Plasminogen Activator Receptor ◽  
Short Term Mortality ◽  
Plasminogen Activator Receptor

Abstract Background: Acute-on-chronic liver failure (ACLF) is a comprehensive syndrome characterized by an acute deterioration of liver function and high short-term mortality rates in patients with chronic liver disease. Objectives: To investigate whether plasma soluble urokinase plasminogen activator receptor (suPAR), a molecule known as a chemokine, is a suitable biomarker for the prognosis of patients with ACLF and the underlying mechanism.Method: A prospective cohort of 282 patients with ACLF from three hospitals in China was included. 88.4% of the group was hepatitis B virus-related ACLF (HBV-related ACLF). Cox regression was used to assess the impact of plasma suPAR and other factors on 30- and 90-day mortality. Reactive oxygen species (ROS) production were detected to explore the role of suPAR in regulating neutrophil function in HBV-related ACLF.Result: There was no difference in plasma suPAR levels between HBV-related and non-HBV-related ACLF. Patients with clinical complications had higher suPAR levels than those without these complications. A significant correlation was also found between suPAR and prognostic scores, infection indicators and inflammatory cytokines. Cox’s regression multivariate analysis identified suPAR>=14.7ng/mL as a predictor for both day 30 and 90 mortality (Area under the ROC curve: 0.751 and 0.742 respectively), independe nt of the MELD and SOFA scores in patients with ACLF. Moreover, we firstly discovered suPAR enhanced neutrophil ROS production in patients with HBV-related ACLF. Conclusions: suPAR was a useful independent biomarker of short-term outcomes in patients with ACLF and might play a key role in the pathogenesis.Trial registration: CNT, NCT02965560. Registered 16 November 2016

scholarly journals Serum Clusterin: A Potential Marker for Assessing the Clinical Severity and Short-Term Prognosis of Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Huimin Liu ◽  
Yuxin Li ◽  
Fangyuan Gao ◽  
Peipei Meng ◽  
Hao Yu ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Liver ◽  
Clinical Severity ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Potential Biomarker ◽  
B Virus ◽  
Normal Controls

Background. Acute-on-chronic liver failure (ACLF) is a clinical syndrome characterized by acute deterioration of liver function and high short-term mortality. Clusterin, with biological functions similar to small heat shock proteins, can protect cells from apoptosis induced by various stressors. The aim of this study was to detect the level of serum clusterin in hepatitis B virus- (HBV-) related ACLF and to assess the predictive value of clusterin for the short-term prognosis of HBV-ACLF. Methods. We detected serum clusterin by ELISA in 108 HBV-ACLF patients, 63 HBV-non-ACLF patients, and 44 normal controls. Results. Serum clusterin was markedly lower in HBV-ACLF patients (median, 51.09 μg/mL) than in HBV-non-ACLF patients (median, 188.56 μg/mL) and normal controls (median, 213.45 μg/mL; all P < 0.05 ). Nonsurviving HBV-ACLF patients who died within 90 days had much lower clusterin levels than did surviving patients, especially those who died within 28 days (nonsurvival group vs. survival group: 39.82 ± 19.34 vs. 72.26 ± 43.52 , P < 0.001 ; survival time ≤ 28 vs. survival time > 28 : median 28.39 vs. 43.22, P = 0.013 ). The results showed that for identifying HBV-ACLF, the sensitivity of clusterin (93.7%) was similar to the sensitivities of the international normalized ratio (INR; 94.4%) and total bilirubin (TBIL; 94.8%), but its specificity (90.7%) was higher than that of prothrombin activity (PTA; 65.8%) and TBIL (69.8%) and was similar to INR (88.9%). As the concentration of clusterin increased, the mortality of HBV-ACLF patients decreased significantly from 59.3% to 7.0%. Clusterin had better ability for predicting the prognosis of HBV-ACLF patients than did the model for end-stage liver disease (MELD) score and the chronic liver failure consortium (CLIF-C) ACLF score (MELD vs. clusterin: P = 0.012 ; CLIF-C ACLF vs. clusterin: P = 0.031 ). Conclusion. Serum clusterin is a potential biomarker for HBV-ACLF which can be used to assess clinical severity and the short-term prognosis of patients with this disease and may help clinicians identify HBV-ACLF with greater specificity and improved prognostic accuracy than existing prognostic markers.

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