Austermann Christian, Schierwagen Robert, Mohr Raphael, Anadol Evrim, Klein Sabine, Pohlmann Alessandra, Jansen Christian, Strassburg Christian P, Schwarze-Zander Carolynne, Boesecke Christoph, Rockstroh Jürgen K, Odenthal Margarete, Trebicka Jonel
Department of Internal Medicine I University of Bonn Bonn Germany.
German Center for Infection Research, partner site Bonn-Cologne Bonn Germany.
Hepatol Commun. 2017 Feb 27;1(1):36-45. doi: 10.1002/hep4.1017. eCollection 2017 Feb.
Nonalcoholic fatty liver disease contributes to liver-related mortality and has a high prevalence among patients with human immunodeficiency virus (HIV). The early detection of steatosis could prevent disease progression through life-style changes. However, as the common serum markers are nonspecific and the gold standard for the detection of nonalcoholic fatty liver disease remains the invasive liver biopsy, its verification is limited. Therefore, the search for novel biomarkers is essential. Several studies have emphasized the role of microRNAs (miRNAs) as biomarkers for certain liver diseases. With our study, we aimed to investigate the potential of miR-200a as a biomarker for liver injury, fibrosis, and steatosis in HIV patients. The study cohort consisted of 89 HIV patients. Clinical and laboratory parameters were assessed twice, within a median follow-up period of 12 months. miR-200a serum levels were determined by real-time polymerase chain reaction and normalized to spiked-in RNA (SV40). miR-200a serum levels showed a significant correlation with the patients' controlled attenuation parameter scores and their body weight at baseline and with alanine aminotransferase serum levels at follow-up. At baseline, we observed a stage-dependent increase in miR-200a serum levels according to the degree of steatosis. More importantly, patients with higher baseline levels of miR-200a recorded a progression of steatosis at follow-up. Remarkably, miR-200a not only reveals a prognostic value for steatosis but possibly also for liver damage and metabolic adaptions as patients with an increase in alanine aminotransferase/aspartate aminotransferase serum levels over time also recorded higher baseline miR-200a levels. : Our study reveals miR-200a not only to be a stage-dependent biomarker of steatosis but also to be a predictor of steatosis progression and probably liver cell injury in HIV patients. (Hepatology Communications 2017;1:36-45).
非酒精性脂肪性肝病会导致肝脏相关死亡率，在人类免疫缺陷病毒（HIV）患者中患病率很高。脂肪变性的早期检测可以通过改变生活方式来预防疾病进展。然而，由于常见的血清标志物缺乏特异性，且非酒精性脂肪性肝病的检测金标准仍是侵入性肝脏活检，其应用受到限制。因此，寻找新型生物标志物至关重要。多项研究强调了微小RNA（miRNA）作为某些肝脏疾病生物标志物的作用。在我们的研究中，我们旨在探讨miR-200a作为HIV患者肝损伤、纤维化和脂肪变性生物标志物的潜力。研究队列包括89名HIV患者。在中位随访期12个月内对临床和实验室参数进行了两次评估。通过实时聚合酶链反应测定miR-200a血清水平，并将其标准化为加入的RNA（SV40）。miR-200a血清水平与患者的控制衰减参数评分、基线时的体重以及随访时的丙氨酸氨基转移酶血清水平显著相关。在基线时，我们观察到根据脂肪变性程度，miR-200a血清水平呈阶段依赖性升高。更重要的是，基线miR-200a水平较高的患者在随访时出现了脂肪变性进展。值得注意的是，miR-200a不仅揭示了脂肪变性的预后价值，还可能揭示了肝损伤和代谢适应的预后价值，因为随着时间推移丙氨酸氨基转移酶/天冬氨酸氨基转移酶血清水平升高的患者，其基线miR-200a水平也较高。我们的研究表明，miR-200a不仅是脂肪变性的阶段依赖性生物标志物，还是HIV患者脂肪变性进展以及可能的肝细胞损伤的预测指标。（《肝脏病学通讯》2017年；1：36 - 45）
