Ura K, Furusyo N, Ogawa E, Hayashi T, Mukae H, Shimizu M, Toyoda K, Murata M, Hayashi J
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Department of Environmental Medicine and Infectious Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Aliment Pharmacol Ther. 2016 Jan;43(1):114-24. doi: 10.1111/apt.13431. Epub 2015 Oct 26.
The Wisteria floribunda agglutinin-positive human Mac-2-binding protein (WFA(+) -M2BP) is a new liver fibrosis glycobiomarker with unique fibrosis-related glyco-alteration. WFA(+) -M2BP is also a useful surrogate marker for the risk of developing hepatocellular carcinoma and for the liver functional reserve.
To evaluate the diagnostic ability of WFA(+) -M2BP for liver fibrosis in the clinical setting and the clinical utility of WFA(+) -M2BP for predicting the efficacy of direct-acting anti-viral (DAA) treatment for chronic hepatitis C patients.
The study included 159 genotype 1 hepatitis C patients who received DAA-based treatment (telaprevir or simeprevir) combined with pegylated-interferon alpha plus ribavirin (108 telaprevir- and 51 simeprevir-based triple treatment). The relation between baseline serum WFA(+) -M2BP and treatment efficacy was evaluated.
The serum WFA(+) -M2BP level significantly increased with the progress of liver fibrosis. Area under the receiver operating characteristic curve analysis identified 2.17 as the cut-off index (COI) for WFA(+) -M2BP for diagnosing advanced fibrosis. The sustained virological response (SVR) rate was significantly, negatively correlated with the serum WFA(+) -M2BP level. Multiple logistic regression analysis found a low serum WFA(+) -M2BP level (<2.17 COI) to be independently associated with SVR (odds ratio, 4.35, P = 0.027). Even for prior nonresponders and patients with the interleukin-28B minor allele or histological advanced fibrosis, treatment outcome was favourable for patients with a low serum WFA(+) -M2BP level.
Serum WFA(+) -M2BP is a non-invasive liver fibrosis marker useful for predicting the efficacy of DAA-based triple therapy for chronic hepatitis C patients.
紫藤凝集素阳性的人巨噬细胞2结合蛋白(WFA(+) -M2BP)是一种新的肝纤维化糖生物标志物,具有独特的与纤维化相关的糖基改变。WFA(+) -M2BP也是肝细胞癌发生风险和肝功能储备的有用替代标志物。
评估WFA(+) -M2BP在临床环境中对肝纤维化的诊断能力以及WFA(+) -M2BP对预测慢性丙型肝炎患者直接抗病毒(DAA)治疗疗效的临床实用性。
该研究纳入了159例接受基于DAA(特拉匹韦或simeprevir)联合聚乙二醇化干扰素α加利巴韦林治疗的基因1型丙型肝炎患者(108例基于特拉匹韦和51例基于simeprevir的三联治疗)。评估基线血清WFA(+) -M2BP与治疗疗效之间的关系。
血清WFA(+) -M2BP水平随肝纤维化进展显著升高。受试者工作特征曲线分析确定2.17为WFA(+) -M2BP诊断晚期纤维化的截断指数(COI)。持续病毒学应答(SVR)率与血清WFA(+) -M2BP水平显著负相关。多因素逻辑回归分析发现低血清WFA(+) -M2BP水平(<2.17 COI)与SVR独立相关(优势比,4.35,P = 0.027)。即使对于先前无应答者以及白细胞介素-28B次要等位基因或组织学晚期纤维化患者,血清WFA(+) -M2BP水平低的患者治疗结局良好。
血清WFA(+) -M2BP是一种非侵入性肝纤维化标志物,可用于预测慢性丙型肝炎患者基于DAA的三联疗法的疗效。