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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 6
Jun.  2024
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Article Contents

Expression levels of serum high-mobility group box 1, soluble CD163, and prostaglandin E2 in patients with hepatitis B virus-related chronic-on-acute liver failure and their value in predicting prognosis

DOI: 10.12449/JCH240610
Research funding:

Medical Science and Technology Research Project of Henan Province (LHGJ20210532)

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  • Corresponding author: YANG Daokun, dk13949620669@163.com (ORCID: 0000-0003-4606-7457)
  • Received Date: 2023-10-12
  • Accepted Date: 2023-12-25
  • Published Date: 2024-06-25
  •   Objective  To investigate the expression levels of serum high-mobility group box 1 (HMGB1), soluble CD163 (sCD163), and prostaglandin E2 (PGE2) in patients with hepatitis B virus-related chronic-on-acute liver failure (HBV-ACLF), and to evaluate the value of the three indicators used alone or in combination in predicting prognosis.  Methods  A total of 76 patients with HBV-ACLF who were hospitalized in Department of Infectious Diseases, The First Affiliated Hospital of Xinxiang Medical University, from July 1, 2022 to September 30, 2023 were enrolled, and according to the 28-day prognosis, they were divided into survival group with 48 patients and death group with 28 patients. General data were collected, Model for End-Stage Liver Disease (MELD) score was calculated, and ELISA was used to measure the serum levels of HMGB1, sCD163, and PGE2. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Spearman rank correlation test was used to analyze the correlation of HMGB1, sCD163, and PGE2 with MELD score; the receiver operating characteristic (ROC) curve was used to analyze the value of HMGB1, sCD163, and PGE2 used alone or in combination in predicting the prognosis of HBV-ACLF patients.  Results  There were significant differences between the two groups in total bilirubin, white blood cell count, the percentage of neutrophils, procalcitonin, serum amyloid A, interleukin-6, serum sodium, and serum creatinine (all P<0.05). Compared with the survival group, the death group had significantly higher serum levels of HMGB1 (Z=-2.997, P=0.003) and sCD163 (Z=-2.972, P=0.003), a significantly higher MELD score (t=-6.997, P<0.001), and a significantly lower serum level of PGE2 (Z=-4.909, P<0.001). The Spearman rank correlation test showed that HMGB1 and sCD163 were positively correlated with MELD score (r=0.431 and 0.319, both P<0.05), while PGE2 was negatively correlated with MELD score (r=-0.412, P<0.05). The ROC curve analysis showed that HMGB1, sCD163, and PGE2 used alone had an area under the ROC curve (AUC) of 0.717, 0.716, and 0.856, respectively, while the combination of the three indicators had the highest predictive value, with an AUC of 0.930, a sensitivity of 0.778, and a specificity of 0.920.  Conclusion  Serum HMGB1, sCD163, and PGE2 used alone or in combination have a good reference value in predicting the prognosis of HBV-ACLF patients, and the combination of the three indicators has the highest predictive value, which holds promise for further observation and research.

     

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  • [1]
    XU MM, KONG M, YU PF, et al. Clinical course and outcome patterns of acute-on-chronic liver failure: a multicenter retrospective cohort study[J]. J Clin Transl Hepatol, 2021, 9( 5): 626- 634. DOI: 10.14218/JCTH.2020.00179.
    [2]
    ABUDEIF A, SAYED E, GALAL GM. Characteristics and predictors of short-term mortality in decompensated cirrhotic patients with acute-on-chronic liver failure[J]. Clin Exp Hepatol, 2022, 8( 4): 300- 308. DOI: 10.5114/ceh.2022.122332.
    [3]
    ABBAS N, RAJORIYA N, ELSHARKAWY AM, et al. Acute-on-chronic liver failure(ACLF) in 2022: have novel treatment paradigms already arrived?[J]. Expert Rev Gastroenterol Hepatol, 2022, 16( 7): 639- 652. DOI: 10.1080/17474124.2022.2097070.
    [4]
    CHEN MJ, LI X, TANG SH. Research progress on multidimensional evaluation of liver function in the prognosis of liver failure patients[J]. Clin J Med Offic, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05.

    陈美娟, 李雪, 汤善宏. 多维度评估肝功能在肝衰竭患者预后中研究进展[J]. 临床军医杂志, 2023, 51( 9): 901- 903, 907. DOI: 10.16680/j.1671-3826.2023.09.05.
    [5]
    LIU Y, YUAN W, FANG M, et al. Determination of HMGB1 in hepatitis B virus-related acute-on-chronic liver failure patients with acute kidney injury: Early prediction and prognostic implications[J]. Front Pharmacol, 2022, 13: 1031790. DOI: 10.3389/fphar.2022.1031790.
    [6]
    GRØNBAEK H, MØLLER HJ, SALIBA F, et al. Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute-on-chronic liver failure and acute decompensation[J]. J Gastroenterol Hepatol, 2021, 36( 1): 240- 248. DOI: 10.1111/jgh.15125.
    [7]
    HUANG XP, WANG Y, CHEN L, et al. Elevated serum prostaglandin E2 predicts the risk of infection in hepatitis B virus-related acute-on-chronic liver failure patients[J]. Asian Pac J Trop Med, 2017, 10( 9): 916- 920. DOI: 10.1016/j.apjtm.2017.08.008.
    [8]
    Chinese Society of Infectious Diseases, Chinese Society of Hepatology. Guidelines for the prevention and treatment of chronic hepatitis B(version 2019)[J]. J Clin Hepatol, 2019, 35( 12): 2648- 2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.

    中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版)[J]. 临床肝胆病杂志, 2019, 35( 12): 2648- 2669. DOI: 10.3969/j.issn.1001-5256.2019.12.007.
    [9]
    Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.

    中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
    [10]
    HERNAEZ R, KRAMER JR, LIU Y, et al. Prevalence and short-term mortality of acute-on-chronic liver failure: A national cohort study from the USA[J]. J Hepatol, 2019, 70( 4): 639- 647. DOI: 10.1016/j.jhep.2018.12.018.
    [11]
    CHEN KD. Serum levels of miR-122 and HMGB1 and their relationship with disease condition and prognosis in patients with HBV-ACLF[J]. Infect Dis Info, 2022, 35( 2): 135- 140. DOI: 10.3969/j.issn.1007-8134.2022.01.007.

    陈科第. HBV-ACLF患者血清miR-122和HMGB1水平及其与病情、预后的关系[J]. 传染病信息, 2022, 35( 2): 135- 140. DOI: 10.3969/j.issn.1007-8134.2022.01.007.
    [12]
    LAI M, WANG X, YAO QW, et al. Predictive value of the initial MELD score and its derivative scores for early survival rate after liver transplantation in patients with liver failure[J]. Ogran Transplant, 2022, 13( 4): 489- 494. DOI: 10.3969/j.issn.1674-7445.2022.04.012.

    赖曼, 王鑫, 姚勤伟, 等. 术后首次MELD评分及其衍生评分对肝衰竭患者肝移植术后早期生存率的预测价值[J]. 器官移植, 2022, 13( 4): 489- 494. DOI: 10.3969/j.issn.1674-7445.2022.04.012.
    [13]
    CHEN R, KANG R, TANG D. The mechanism of HMGB1 secretion and release[J]. Exp Mol Med, 2022, 54( 2): 91- 102. DOI: 10.1038/s12276-022-00736-w.
    [14]
    FANG P, DOU B, LIANG J, et al. Quercetin reduces oxidative stress and apoptosis by inhibiting HMGB1 and its translocation, thereby alleviating liver injury in ACLF rats[J]. Evid Based Complement Alternat Med, 2021, 2021: 2898995. DOI: 10.1155/2021/2898995.
    [15]
    HOU W, WEI X, LIANG J, et al. HMGB1-induced hepatocyte pyroptosis expanding inflammatory responses contributes to the pathogenesis of acute-on-chronic liver failure(ACLF)[J]. J Inflamm Res, 2021, 14: 7295- 7313. DOI: 10.2147/JIR.S336626.
    [16]
    NI YA, CHEN H, NIE H, et al. HMGB1: An overview of its roles in the pathogenesis of liver disease[J]. J Leukoc Biol, 2021, 110( 5): 987- 998. DOI: 10.1002/JLB.3MR0121-277R.
    [17]
    RASZEJA-WYSZOMIRSKA J, NIEWIŃSKI G, GRACZYŃSKA A, et al. Clinical implication of plasma CD163 in patients with acute-on-chronic liver failure[J]. Transplant Proc, 2022, 54( 4): 1011- 1016. DOI: 10.1016/j.transproceed.2022.02.048.
    [18]
    NIELSEN MC, HVIDBJERG GANTZEL R, CLÀRIA J, et al. Macrophage activation markers, CD163 and CD206, in acute-on-chronic liver failure[J]. Cells, 2020, 9( 5). DOI: 10.3390/cells9051175.
    [19]
    TRIANTAFYLLOU E, WOOLLARD KJ, MCPHAIL M, et al. The role of monocytes and macrophages in acute and acute-on-chronic liver failure[J]. Front Immunol, 2018, 9: 2948. DOI: 10.3389/fimmu.2018.02948.
    [20]
    ZHAO R, WU W, ZHOU Z, et al. Prognostic utility of novel biomarkers in acute-on-chronic liver failure(ACLF) associated with hepatitis B: A multicenter prospective study[J]. Hepatol Res, 2019, 49( 1): 42- 50. DOI: 10.1111/hepr.13251.
    [21]
    GRONBAK H, RODGAARD-HANSEN S, AAGAARD NK, et al. Macrophage activation markers predict mortality in patients with liver cirrhosis without or with acute-on-chronic liver failure(ACLF)[J]. J Hepatol, 2016, 64( 4): 813- 822. DOI: 10.1016/j.jhep.2015.11.021.
    [22]
    WANG Y, CHEN C, QI J, et al. Altered PGE2-EP2 is associated with an excessive immune response in HBV-related acute-on-chronic liver failure[J]. J Transl Med, 2019, 17( 1): 93. DOI: 10.1186/s12967-019-1844-0.
    [23]
    HANGAI S, AO T, KIMURA Y, et al. PGE2 induced in and released by dying cells functions as an inhibitory DAMP[J]. Proc Natl Acad Sci U S A, 2016, 113( 14): 3844- 3849. DOI: 10.1073/pnas.1602023113.
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