Takakusagi Satoshi, Sato Ken, Marubashi Kyoko, Kizawa Kazuko, Kosone Takashi, Kakizaki Satoru, Takagi Hitoshi, Uraoka Toshio
Department of Gastroenterology and Hepatology, Kusunoki Hospital, Fujioka, Gunma 375-0024, Japan.
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan.
Biomedicines. 2021 Jun 8;9(6):660. doi: 10.3390/biomedicines9060660.
The clinical significance of mac-2 binding protein glycosylation isomer (M2BPGi) levels based on virological responses due to antiviral therapy has not been fully evaluated. We compared the change before and 24 weeks after the therapy with daclatasvir and asunaprevir (DCV+ASV) of M2BPGi levels with those of other fibrosis markers in 73 chronic hepatitis C cases. Moreover, we examined the association between M2BPGi levels and hepatocarcinogenesis in sustained virological response (SVR) and non-SVR cases. M2BPGi levels were significantly improved at post-treatment week 24 (PTW24) in SVR but not non-SVR cases, whereas the changes of other fibrosis markers showed the same tendency in both SVR and non-SVR cases. M2BPGi levels were well correlated with other fibrosis markers at baseline but not PTW24. The incidence of hepatocellular carcinoma (HCC) was significantly associated with M2BPGi levels at PTW24. The achievement of SVR significantly affected the improvement of M2BPGi levels that best reflected the effect of direct-acting antivirals among the fibrosis markers. Furthermore, M2BPGi levels at PTW24 were also associated with the incidence of HCC in only SVR cases. However, the rapid decrease of M2BPGi levels might reflect the amelioration of liver inflammation rather than the improvement of liver fibrosis, which should be further elucidated.
基于抗病毒治疗的病毒学应答，巨噬细胞2结合蛋白糖基化异构体（M2BPGi）水平的临床意义尚未得到充分评估。我们比较了73例慢性丙型肝炎患者接受daclatasvir和asunaprevir（DCV+ASV）治疗前及治疗24周后M2BPGi水平的变化与其他纤维化标志物水平的变化。此外，我们还研究了持续病毒学应答（SVR）和非SVR病例中M2BPGi水平与肝癌发生之间的关联。在SVR病例中，治疗后第24周（PTW24）时M2BPGi水平显著改善，而非SVR病例则未改善，而其他纤维化标志物的变化在SVR和非SVR病例中均呈现相同趋势。M2BPGi水平在基线时与其他纤维化标志物密切相关，但在PTW24时则不然。肝细胞癌（HCC）的发生率与PTW24时的M2BPGi水平显著相关。SVR的实现显著影响了M2BPGi水平的改善，M2BPGi是纤维化标志物中最能反映直接抗病毒药物疗效的指标。此外，仅在SVR病例中，PTW24时的M2BPGi水平也与HCC的发生率相关。然而，M2BPGi水平的快速下降可能反映了肝脏炎症的改善而非肝纤维化的改善，这一点有待进一步阐明。
