Stickel F, Urbaschek R, Schuppan D, Poeschl G, Oesterling C, Conradt C, McCuskey R S, Simanowski U A, Seitz H K
I. Department of Medicine, University of Erlangen-Nurnberg, Erlangen, Germany.
Dig Dis Sci. 2001 Sep;46(9):2025-32. doi: 10.1023/a:1010616021659.
Hepatic fibrosis in alcoholic liver disease often heralds progression to cirrhosis and, therefore, noninvasive parameters are required for early diagnosis and follow-up. Collagens VI and XIV, procollagen-III-N-propeptide, hyaluronic acid, and active transforming growth factor-beta1 (TGF-beta1) were measured in healthy volunteers, patients with alcoholic cirrhosis, and heavy drinkers without cirrhosis. Noncirrhotic alcoholics were assigned to two groups with either normal aspartate aminotransferase or levels > or = 2 normal. Collagens VI and XIV were elevated in all alcoholic patients compared to controls (P < 0.0001, all instances). Procollagen-III-N-propeptide and hyaluronic acid levels were higher in alcoholic patients with elevated liver enzymes and in cirrhotics as compared to controls. Procollagen-III-N-propeptide revealed a significant correlation with serum levels of TGF-beta1 (P < 0.0001). Collagens VI, and XIV, procollagen-III-N-propeptide, and hyaluronic acid appear to be sensitive markers indicating fibrotic transformation in alcoholics. The correlation between procollagen-III-N-propeptide and TGF-beta1 emphasizes its role in hepatic fibrogenesis.
酒精性肝病中的肝纤维化往往预示着病情进展为肝硬化，因此，早期诊断和随访需要非侵入性参数。对健康志愿者、酒精性肝硬化患者和无肝硬化的重度饮酒者测定了VI型和XIV型胶原、前胶原III-N-端前肽、透明质酸和活性转化生长因子-β1（TGF-β1）。非肝硬化酒精性患者被分为两组，一组天冬氨酸转氨酶正常，另一组天冬氨酸转氨酶水平≥正常水平的2倍。与对照组相比，所有酒精性患者的VI型和XIV型胶原均升高（所有情况P<0.0001）。与对照组相比，肝酶升高的酒精性患者和肝硬化患者的前胶原III-N-端前肽和透明质酸水平更高。前胶原III-N-端前肽与血清TGF-β1水平呈显著相关性（P<0.0001）。VI型和XIV型胶原、前胶原III-N-端前肽和透明质酸似乎是提示酒精性患者纤维化转变的敏感标志物。前胶原III-N-端前肽与TGF-β1之间的相关性强调了其在肝纤维化形成中的作用。
