Ji Liujuan, Mei Xue, Yuan Wei, Guo Hongying, Zhang Yuyi, Zhang Zhengguo, Zou Ying, Liu Yu, Zhu Hui, Qian Zhiping, Shen Yinzhong
Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Viruses. 2024 Dec 20;16(12):1960. doi: 10.3390/v16121960.
This study aimed to investigate the impact of IL-35 on the prognosis of patients with HBV-ACLF. We recruited 69 patients with HBV-ACLF, 20 patients with chronic hepatitis B (CHB), 17 patients with liver cirrhosis (LC), and 20 healthy controls (HCs) from a regional infectious disease treatment center in China. Plasma levels of IL-35 at baseline were detected using ELISA. Plasma IL-35 levels in the HBV-ACLF group were the highest among all four groups. Furthermore, survivors exhibited significantly higher IL-35 levels than non-survivors ( < 0.001). IL-35 levels correlated with MELD (r = -0.678, < 0.001), COSSH-ACLF IIs (r = -0.581, < 0.001), alpha-fetoprotein (AFP) (r = 0.433, < 0.001), creatinine (Cr) (r =-0.396, = 0.001), and lactate (r =-0.38, =0.001). The combination of plasma IL-35 and MELD score had the highest mortality prediction efficiency, with an area under the curve (AUC) of 0.895 (95% CI: 0.812-0.978, < 0.001), a sensitivity of 80.6%, and a specificity of 93.9%. Additionally, the Kaplan-Meier analysis revealed that lower levels of IL-35 (≤191.5pg/mL) were associated with poorer survival rates in HBV-ACLF patients ( < 0.001). Our results demonstrated that IL-35 could be an effective predictive marker for the prognosis of HBV-ACLF and improve the predictive performance when combined with the MELD score.
本研究旨在探讨白细胞介素-35（IL-35）对乙型肝炎相关慢加急性肝衰竭（HBV-ACLF）患者预后的影响。我们从中国一家地区性传染病治疗中心招募了69例HBV-ACLF患者、20例慢性乙型肝炎（CHB）患者、17例肝硬化（LC）患者和20例健康对照者（HCs）。采用酶联免疫吸附测定（ELISA）法检测基线时血浆IL-35水平。HBV-ACLF组的血浆IL-35水平在所有四组中最高。此外，存活者的IL-35水平显著高于非存活者（<0.001）。IL-35水平与终末期肝病模型（MELD）评分（r=-0.678，<0.001）、中国慢加急性肝衰竭（COSSH-ACLF）IIs评分（r=-0.581，<0.001）、甲胎蛋白（AFP）（r=0.433，<0.001）、肌酐（Cr）（r=-0.396，=0.001）和乳酸（r=-0.38，=0.001）相关。血浆IL-35与MELD评分联合使用时死亡率预测效率最高，曲线下面积（AUC）为0.895（95%可信区间：0.812-0.978，<0.001），敏感性为80.6%，特异性为93.9%。此外，Kaplan-Meier分析显示，较低水平的IL-35（≤191.5pg/mL）与HBV-ACLF患者较差的生存率相关（<0.001）。我们的结果表明，IL-35可能是HBV-ACLF患者预后的有效预测标志物，与MELD评分联合使用时可提高预测性能。
