Peschel Georg, Grimm Jonathan, Gülow Karsten, Müller Martina, Buechler Christa, Weigand Kilian
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany.
Diagnostics (Basel). 2020 Nov 19;10(11):974. doi: 10.3390/diagnostics10110974.
Hepatitis C virus (HCV)-induced inflammation contributes to progressive liver disease. The chemoattractant protein chemerin is associated with systemic inflammation. We hypothesized that chemerin is a biomarker that predicts the severity of liver disease in HCV patients. Furthermore, we investigated whether serum chemerin levels change during the course of HCV treatment using direct-acting antivirals (DAAs). Therefore, we measured serum concentration of chemerin in a cohort of 82 HCV-infected patients undergoing DAA treatment. Serum chemerin was positively associated with leukocyte count and negatively with markers of hepatic function and the model of end-stage liver disease (MELD) score. Low circulating chemerin levels significantly correlated with advanced liver fibrosis and cirrhosis as measured by the fibrosis-4 (FIB-4) score, the aminotransferase/platelet (AST/PLT) ratio index (APRI) score and the non-alcoholic fatty liver disease (NAFLD) score. Chemerin did not correlate with viral load or viral genotype. Treatment with DAAs did not improve MELD score and leukocyte count within the observation period, up to three months after the end of DAA treatment. Accordingly, chemerin levels remained unchanged during the treatment period. We conclude that low circulating chemerin is a noninvasive biomarker for hepatic dysfunction and advanced liver fibrosis and cirrhosis in HCV infection.
丙型肝炎病毒(HCV)引起的炎症会导致肝病进展。趋化因子蛋白瑞托蛋白与全身炎症有关。我们假设瑞托蛋白是预测HCV患者肝病严重程度的生物标志物。此外,我们研究了使用直接抗病毒药物(DAA)治疗HCV期间血清瑞托蛋白水平是否会发生变化。因此,我们测量了82例接受DAA治疗的HCV感染患者队列中的血清瑞托蛋白浓度。血清瑞托蛋白与白细胞计数呈正相关,与肝功能指标和终末期肝病模型(MELD)评分呈负相关。通过纤维化-4(FIB-4)评分、转氨酶/血小板(AST/PLT)比值指数(APRI)评分和非酒精性脂肪性肝病(NAFLD)评分测量,低循环瑞托蛋白水平与晚期肝纤维化和肝硬化显著相关。瑞托蛋白与病毒载量或病毒基因型无关。在观察期内,直至DAA治疗结束后三个月,DAA治疗均未改善MELD评分和白细胞计数。因此,治疗期间瑞托蛋白水平保持不变。我们得出结论,低循环瑞托蛋白是HCV感染中肝功能障碍、晚期肝纤维化和肝硬化的非侵入性生物标志物。