TY - JOUR
T1 - Serum Apoptosis Markers in Acute Liver Failure
T2 - A Pilot Study
AU - Rutherford, Anna E.
AU - Hynan, Linda S.
AU - Borges, Carolina B S
AU - Forcione, David G.
AU - Blackard, Jason T.
AU - Lin, Wenyu
AU - Gorman, April R.
AU - Shaikh, Obaid Shakil
AU - Reuben, Adrian
AU - Harrison, Edwyn
AU - Reddy, K. Rajender
AU - Le, William M.
AU - Chung, Raymond T.
N1 - Funding Information:
Supported by NIDDK 2 UO1 DK058369, which was previously NIDDK R01 DK058369.
PY - 2007/12
Y1 - 2007/12
N2 - Background & Aims: We sought to determine whether circulating apoptotic markers are altered in acute liver failure (ALF), differ with etiology, or predict clinical outcome in this condition. Methods: Serum levels of soluble Fas (sFas), tumor necrosis factor-alpha (TNF-α), hepatocyte growth factor (HGF), and interleukin-6 (IL-6) were measured in 67 acute liver failure patients, as well as controls. In a subset of the groups, we measured serum M-30 antigen, an exposed neoepitope from caspase cleavage. We also assessed M-30 immunoreactivity in liver tissue of ALF patients and controls. Results: Median levels for TNF-α, HGF, IL-6, and M-30 antigen were at least 10-fold greater in ALF than in hepatitis C virus or normal controls (P < .0001). Median day 1 sFas, day 3 sFas, and day 1 HGF levels varied according to etiology of acute liver failure (P = .004, P = .011, and P = .019, respectively), with values for drug-induced liver injury and acetaminophen-related ALF higher than other etiologies. Median M-30 antigen levels were significantly higher in patients who were transplanted and/or died (2183 U/L) than spontaneous survivors (1004 U/L) (P = .026). M-30 immunoreactivity in liver tissue was significantly greater in ALF patients than HCV controls (P = .004). Conclusions: TNF-α, HGF, IL-6, and M-30 antigen were significantly elevated in ALF. High levels of sFas and HGF might help to confirm a diagnosis of drug-induced liver injury or acetaminophen-related ALF. Higher levels of M-30 antigen are associated with poor clinical outcomes in ALF.
AB - Background & Aims: We sought to determine whether circulating apoptotic markers are altered in acute liver failure (ALF), differ with etiology, or predict clinical outcome in this condition. Methods: Serum levels of soluble Fas (sFas), tumor necrosis factor-alpha (TNF-α), hepatocyte growth factor (HGF), and interleukin-6 (IL-6) were measured in 67 acute liver failure patients, as well as controls. In a subset of the groups, we measured serum M-30 antigen, an exposed neoepitope from caspase cleavage. We also assessed M-30 immunoreactivity in liver tissue of ALF patients and controls. Results: Median levels for TNF-α, HGF, IL-6, and M-30 antigen were at least 10-fold greater in ALF than in hepatitis C virus or normal controls (P < .0001). Median day 1 sFas, day 3 sFas, and day 1 HGF levels varied according to etiology of acute liver failure (P = .004, P = .011, and P = .019, respectively), with values for drug-induced liver injury and acetaminophen-related ALF higher than other etiologies. Median M-30 antigen levels were significantly higher in patients who were transplanted and/or died (2183 U/L) than spontaneous survivors (1004 U/L) (P = .026). M-30 immunoreactivity in liver tissue was significantly greater in ALF patients than HCV controls (P = .004). Conclusions: TNF-α, HGF, IL-6, and M-30 antigen were significantly elevated in ALF. High levels of sFas and HGF might help to confirm a diagnosis of drug-induced liver injury or acetaminophen-related ALF. Higher levels of M-30 antigen are associated with poor clinical outcomes in ALF.
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U2 - 10.1016/j.cgh.2007.08.007
DO - 10.1016/j.cgh.2007.08.007
M3 - Article
C2 - 17967565
AN - SCOPUS:36549015573
SN - 1542-3565
VL - 5
SP - 1477
EP - 1483
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 12
ER -