Department of Gastroenterology, Marmara University School of Medicine, İstanbul, Turkey.
Department of Pathology, Marmara University School of Medicine, İstanbul, Turkey.
Turk J Gastroenterol. 2020 Oct;31(10):681-687. doi: 10.5152/tjg.2020.19403.
BACKGROUND/AIMS: Specific serum markers reflecting hepatic inflammation and fibrosis are required to tailor the treatment strategies in non-alcoholic steatohepatitis (NASH). We aimed to investigate the roles of myeloperoxidase (MPO) and calprotectin in predicting the hepatic inflammation status and disease severity in NASH.
A total of 48 patients with biopsy-proven NASH and 25 healthy volunteers with normal weight were prospectively enrolled. Serum MPO and calprotectin levels were compared between the NASH and control groups. Hepatic MPO and calprotectin expressions were compared in terms of histologic non-alcoholic fatty liver disease activity scores (NAS) (low NAS [≤4] vs. high NAS [>5]) and fibrosis stage (insignificant [F0-1]/significant [F2-4]).
Serum MPO and calprotectin levels were not significantly different between the NASH and control groups. In the subgroup analysis, hepatic MPO expression was significantly increased in patients with NASH with significant fibrosis than in those with insignificant fibrosis (F2-4: 7.04±3.61 vs. F0-1: 4.83±2.42, p=0.01). We found no difference between the groups with low and high NAS with regard to serum MPO and calprotectin levels and hepatic MPO and calprotectin expressions.
This study demonstrated that hepatic MPO expression can reflect advanced fibrosis in NASH. However, when serum MPO and calprotectin levels were evaluated as potential serum markers, both did not associate with hepatic inflammation status and fibrosis stage in NASH. Therefore, our study results preclude their use as serum markers for hepatic inflammation in NASH.
背景/目的：需要特定的血清标志物来反映肝炎症和纤维化，以调整非酒精性脂肪性肝炎（NASH）的治疗策略。我们旨在研究髓过氧化物酶（MPO）和钙卫蛋白在预测 NASH 肝炎症状态和疾病严重程度中的作用。
共前瞻性纳入 48 例经活检证实的 NASH 患者和 25 名体重正常的健康志愿者。比较 NASH 组和对照组之间的血清 MPO 和钙卫蛋白水平。根据组织学非酒精性脂肪性肝病活动评分（NAS）（低 NAS [≤4]与高 NAS [>5]）和纤维化分期（无显著 [F0-1]/显著 [F2-4]）比较肝 MPO 和钙卫蛋白的表达。
NASH 组和对照组之间的血清 MPO 和钙卫蛋白水平无显著差异。在亚组分析中，与无显著纤维化的患者相比，具有显著纤维化的 NASH 患者肝 MPO 表达显著增加（F2-4：7.04±3.61 vs. F0-1：4.83±2.42，p=0.01）。在低和高 NAS 组之间，血清 MPO 和钙卫蛋白水平以及肝 MPO 和钙卫蛋白表达均无差异。
本研究表明，肝 MPO 表达可反映 NASH 的晚期纤维化。然而，当评估血清 MPO 和钙卫蛋白水平作为潜在的血清标志物时，两者均与 NASH 的肝炎症状态和纤维化分期无关。因此，我们的研究结果排除了它们作为 NASH 肝炎症的血清标志物的用途。
