Department of Cardiology, Hillel Yaffe Medical Center Affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
Department of Clinical Biochemistry, Hadassah Hebrew University Hospital, Jerusalem 91120, Israel.
Medicina (Kaunas). 2023 Mar 2;59(3):496. doi: 10.3390/medicina59030496.
: Neutrophil infiltration is an established signature of Non-Alcoholic Fatty Liver Disease (NAFLD) and Steatohepatitis (NASH). The most abundant neutrophilic peptide, alpha-defensin, is considered a new evolving risk factor in the inflammatory milieu, intimately involved in lipid mobilization. Our objective is to assess for potential association between alpha-defensin immunostains and NAFLD severity. : We retrospectively investigated the liver biopsies of NAFLD/NASH patients, obtained at Hillel Yaffe Medical center between the years 2012 and 2016. Patients' characteristics were recorded, including relevant blood tests at the time of biopsy. Each biopsy was semi-quantitatively scored using NAFLD Activity Score (NAS) and NASH fibrosis stage. The biopsies were immunostained for alpha-defensin. The precipitation of alpha-defensin was correlated to NAS and fibrosis. : A total of 80 biopsies were evaluated: male ratio 53.2%, mean age 44.9 ± 13.2 years, 54 had fibrosis grades 0-2, and 26 were grade 3-4. Conventional metabolic risk factors were more frequent in the high-grade fibrosis group. Immunostaining for alpha-defensin disclosed higher intensity (a.u.) in grade 3-4 fibrosis relative to grades 0-2, 25% vs. 6.5%, < 0.05, respectively. Moreover, alpha-defensin staining was nicely co-localized with fibrosis. : In our group of NASH/NAFLD patients, higher metabolic risk profile was associated with higher fibrosis grade. Immunostaining for alpha-defensin showed patchy intense staining concordant with high fibrosis, nicely co-localized with histological fibrosis. Whether alpha-defensin is a profibrotic risk factor or merely risk marker for fibrosis must be clarified in future studies.
中性粒细胞浸润是非酒精性脂肪性肝病（NAFLD）和脂肪性肝炎（NASH）的一个既定特征。最丰富的中性粒细胞肽-α防御素被认为是炎症环境中一个新的不断发展的风险因素，与脂质动员密切相关。我们的目的是评估α防御素免疫染色与 NAFLD 严重程度之间的潜在相关性。
我们回顾性地研究了 2012 年至 2016 年在 Hillel Yaffe 医学中心获得的 NAFLD/NASH 患者的肝活检。记录了患者的特征，包括活检时的相关血液检查。使用 NAFLD 活动评分（NAS）和 NASH 纤维化分期对每个活检进行半定量评分。对α防御素进行免疫染色。α防御素的沉淀与 NAS 和纤维化相关。
共评估了 80 例活检：男性比例为 53.2%，平均年龄为 44.9 ± 13.2 岁，54 例纤维化程度为 0-2 级，26 例为 3-4 级。在高纤维化组中，常规代谢危险因素更为常见。α防御素免疫染色显示 3-4 级纤维化的强度（AU）高于 0-2 级，分别为 25%和 6.5%，<0.05。此外，α防御素染色与纤维化很好地共定位。
在我们的 NASH/NAFLD 患者组中，较高的代谢风险谱与较高的纤维化程度相关。α防御素免疫染色显示出与高纤维化一致的斑片状强染色，与组织学纤维化很好地共定位。α防御素是一种促纤维化的危险因素还是纤维化的风险标志物，必须在未来的研究中阐明。
