Department of Gastroenterology/Hepatology, Charité University Medicine Berlin, Berlin, Germany.
Department of Internal Medicine I, University Clinic Bonn, Bonn, Germany.
PLoS One. 2020 Apr 17;15(4):e0231701. doi: 10.1371/journal.pone.0231701. eCollection 2020.
Liver cirrhosis represents the common end-stage of chronic liver diseases regardless of its etiology. Patients with compensated disease are mostly asymptomatic, however, progression to a decompensated disease stage is common. The available stratification strategies are often unsuitable to identify patients with a higher risk for disease progression and a limited prognosis. SIBLINGs, soluble glycophosphoproteins, are secreted into the blood by immune-cells. While osteopontin, the most prominent member of the SIBLINGs family, has been repeatedly associated with liver cirrhosis, data on the diagnostic and/or prognostic value of bone sialoprotein (BSP) are scarce and partly inconclusive. In this study, we analyzed the diagnostic and prognostic potential of circulating BSP in comparison to other standard laboratory markers in a large cohort of patients with liver cirrhosis receiving transjugular intrahepatic portosystemic shunt (TIPS). Serum levels of BSP were similar in patients with different disease stages and were not indicative for prognosis. Interestingly, BSP serum levels did correlate inversely with portal pressure, as well as its surrogates such as platelet count, the portal vein cross-sectional area and correlated positively with the portal venous velocity. In summary, our data highlight that BSP might represent a previously unrecognized marker for portal hypertension in patients with liver cirrhosis.
肝硬化是各种慢性肝病发展的共同终末阶段,无论其病因如何。代偿期疾病患者大多无症状,但进展为失代偿期疾病较为常见。现有的分层策略通常不适合识别疾病进展风险较高和预后有限的患者。SIBLINGs(可溶性糖基磷蛋白)是免疫细胞分泌到血液中的糖蛋白。骨桥蛋白(osteopontin)是 SIBLINGs 家族中最突出的成员,它与肝硬化反复相关,但关于骨唾液蛋白(bone sialoprotein,BSP)的诊断和/或预后价值的数据很少且部分不确定。在这项研究中,我们分析了循环 BSP 在经颈静脉肝内门体分流术(TIPS)治疗的大量肝硬化患者中与其他标准实验室标志物相比的诊断和预后潜力。不同疾病阶段患者的 BSP 血清水平相似,不能提示预后。有趣的是,BSP 血清水平与门静脉压力及其替代指标(如血小板计数、门静脉截面积)呈负相关,与门静脉流速呈正相关。总之,我们的数据强调了 BSP 可能代表肝硬化患者门静脉高压的一个以前未被认识的标志物。