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 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.

Clinical Features of Hepatitis C Virus-Related Acute-On-Chronic Liver Failure in a Korean Population

2021 ◽  
Author(s):  
Jung Woo Choi ◽  
Jin-Kyu Cho ◽  
Sang Soo Lee ◽  
Jae Heon Kim ◽  
Hankyu Jeon ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
B Virus ◽  
Short Term Mortality ◽  
Very High

Abstract Background Acute-on-chronic liver failure (ACLF) is a widely recognized concept in which acute decompensation (AD) in patients with cirrhosis results in organ failures and high short-term mortality. However, few studies reflecting the various etiologies of cirrhosis are available. We aimed to investigate the clinical features of patients with hepatitis C virus (HCV)-related ACLF. Methods Between January 2005 and December 2018, 109 HCV-related cirrhosis patients who were hospitalized for AD (ascites, hepatic encephalopathy, gastrointestinal hemorrhage, and/or bacterial infection) were enrolled for ACLF defined by European Association for the Study of the Liver (EASL). Results ACLF developed in 35 patients (32.1%) on admission. Eight patients had ACLF grade 1, eight had ACLF grade 2, and 19 had ACLF grade 3. The 28-day and 90-day mortality rates were very low (2.7% and 5.4%, respectively) in patients without ACLF and very high (60.0% and 74.3%, respectively) in those with ACLF. In patients with HCV-related ACLF, the prevalence of liver failure was very low (17.1%), whereas that of kidney failure was very high (71.4%) compared to previous studies on hepatitis B virus-related ACLF and alcohol-related ACLF. Compared with all other prognostic scores, Chronic liver failure Consortium Organ Failure score most accurately predicted 90-day mortality, with an area under the receiver operator characteristic of 0.921. Conclusions HCV-related ACLF has unique clinical characteristics that are distinct from hepatitis B virus-related and alcohol-related ACLF. ACLF defined by EASL can be useful in predicting short-term mortality in HCV-related cirrhosis.

APACHE II score is superior to SOFA, CTP and MELD in predicting the short-term mortality in patients with acute-on-chronic liver failure (ACLF)

2013 ◽  
Vol 14 (9) ◽  
pp. 484-490 ◽  
Author(s):  
Ajay Duseja ◽  
Narendra S Choudhary ◽  
Sachin Gupta ◽  
Radha Krishan Dhiman ◽  
Yogesh Chawla
Keyword(s):  
Liver Failure ◽  
Chronic Liver ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure: an important prognostic indicator

2014 ◽  
Vol 13 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Jorge A. López-Velázquez ◽  
Norberto C. Chávez-Tapia ◽  
Guadalupe Ponciano-Rodríguez ◽  
Vicente Sánchez-Valle ◽  
Stephen H. Caldwell ◽  
...  
Keyword(s):  
Liver Failure ◽  
Prognostic Indicator ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Assessment of scoring systems for acute-on-chronic liver failure at predicting short-term mortality in patients with alcoholic hepatitis

2016 ◽  
Vol 22 (41) ◽  
pp. 9205 ◽  
Author(s):  
Hee Yeon Kim ◽  
Chang Wook Kim ◽  
Tae Yeob Kim ◽  
Do Seon Song ◽  
Dong Hyun Sinn ◽  
...  
Keyword(s):  
Liver Failure ◽  
Alcoholic Hepatitis ◽  
Scoring Systems ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

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.

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