Letter: Myokines Are Also Associated With Disease Course in Primary Biliary Cholangitis

Abstract

We read the recent article by Kaur et al. [1] with great interest. This is the one of the first researches to explore the association of circulating myokines with disease spectrum, progression, mortality, systemic inflammation, malnutrition and hyperammonaemia in alcohol-associated liver disease (ALD). We appreciate the innovative work of the authors. This study demonstrated that myostatin increased and decorin decreased along the ALD spectrum, in addition to their potential in predicting disease progression and prognosis. Our related research has consistently focused on primary biliary cholangitis (PBC). Previous studies have shown that sarcopenia is common in PBC patients [2, 3], as well as elevated levels of inflammation [4]. However, studies that investigated the changes of these myokines between different stages of PBC is limited. Therefore, we want to examine the changes of these two myokines in the context of immune-mediated PBC at different stages.

We used plasma from 72 PBC patients, with half from noncirrhotic patients and half from cirrhotic patients, which also included both compensated and decompensated patients. Human myostatin (Elabscience, E-EL-H1437) and decorin (Boster, EK0749) ELISA kits were used to measure the plasma level of myostatin and decorin. Statistical analysis was performed using Student's t-test or Mann–Whitney U-test and one-way ANOVA was used for multiple group comparisons with Bonferroni correction.

Our results were similar to the findings of Kaur et al. First, as shown in Figure 1A, the plasma level of myostatin in cirrhotic patients were significantly higher than those in noncirrhotic patients (p = 0.0097), while level of decorin were significantly lower in the cirrhotic group (p < 0.0001). Furthermore, myostatin levels were significantly higher in decompensated patients compared to compensated ones (p = 0.0029), while decorin levels showed an opposite trend, p = 0.0250 (Figure 1B). Overall, we found that plasma myostatin levels increased whereas decorin levels decreased as the disease progressed, overall p < 0.0001 (Figure 1C).

In conclusion, our data showed the changes in plasma levels of myostatin and decorin in the PBC disease spectrum, which were similar to those in ALD patients, suggesting association of myostatin and decorin with disease progression and broad applicability of myokines as potential biomarkers in chronic liver diseases. However, further studies are needed for validation.

Leyu Zhou: conceptualization, formal analysis, writing – original draft. Yanyi Zheng: investigation, data curation. Xiaoli Fan: conceptualization, funding acquisition, data curation, writing – review and editing. Li Yang: supervision, conceptualization, funding acquisition.

The authors declare no conflicts of interest.

This article is linked to Kaur et al papers. To view these articles, visit https://doi.org/10.1111/apt.18202, https://doi.org/10.1111/apt.18285 and https://doi.org/10.1111/apt.18329.