Serum exosome-derived ALDH1A1 can greatly predict the prognosis of patients with hepatitis E virus-related acute liver failure.

IF 3.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Hepatobiliary & Pancreatic Diseases International Pub Date : 2024-12-25 DOI:10.1016/j.hbpd.2024.12.007

An-Quan Shang, Hong Yan, Ze Xiang, Jia-Qi Chen, Bin Jiang, Chun Jiang, Bai Ling, Jian Wu

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Abstract

Background: Despite the insights into the role of aldehyde dehydrogenase 1 family member A1 (ALDH1A1) in various liver diseases, the expression and its prognostic significance in patients with hepatitis E virus-related acute liver failure (HEV-ALF) remain unclear. This study delved into the assessment of serum exosome-derived ALDH1A1 expression and its prognostic implications for HEV-ALF patients.

Methods: Between January 2018 and December 2023, a total of 226 individuals with acute hepatitis E (AHE) and 210 patients with HEV-ALF were recruited from member units of Chinese Consortium for the Study of Hepatitis E. According to the number of organ failure, we categorized 210 HEV-ALF patients into three groups: two organs failure (n = 131), three organs failure (n = 46), and more than three organs failure (n = 33). In addition, 200 health controls from Suzhou Municipal Hospital were included.

Results: The levels of serum exosome-derived ALDH1A1 in HEV-ALF patients were significantly higher than those in AHE patients and health controls (both P < 0.05). Furthermore, the levels of serum exosome-derived ALDH1A1 were the highest in more than three organs failure group, followed by three organs failure group and two organs failure group (all P < 0.001). Moreover, serum exosome-derived ALDH1A1 was positively correlated with total bilirubin in HEV-ALF patients (r = 0.315, P < 0.001). The comparisons of serum exosome-derived ALDH1A1 levels in treatment response showed that serum exosome-derived ALDH1A1 levels were decreased in the improvement group, while increased in the fluctuation and deterioration groups (all P < 0.001). Moreover, serum exosome-derived ALDH1A1 was an independent risk factor for predicting the 30-day mortality (P < 0.001). Furthermore, the area under the receiver operating characteristic curve was 0.943, with the sensitivity of 94.87 % and specificity of 87.72 %, indicating the robust decision-making ability. However, no significant differences were found in serum exosome-derived ALDH1A1 levels between patients aged < 60 and ≥ 60 years old (P = 0.131).

Conclusions: Serum exosome-derived ALDH1A1 can greatly predict the prognosis of HEV-ALF patients.

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血清外泌体来源的ALDH1A1对戊型肝炎病毒相关性急性肝衰竭患者的预后有很大的预测作用。

背景：尽管醛脱氢酶1家族成员A1 （ALDH1A1）在多种肝脏疾病中的作用已有深入研究，但其在戊型肝炎病毒相关性急性肝衰竭（HEV-ALF）患者中的表达及其预后意义尚不清楚。本研究深入研究了血清外泌体来源的ALDH1A1表达及其对HEV-ALF患者预后的影响。方法：2018年1月至2023年12月，从中国戊型肝炎研究联盟成员单位共招募226例急性戊型肝炎（AHE）患者和210例HEV-ALF患者。根据器官衰竭的数量，我们将210例HEV-ALF患者分为三组：两器官衰竭（n = 131）、三器官衰竭（n = 46）和三器官以上衰竭（n = 33）。此外，还纳入了苏州市立医院的200名健康对照者。结果：HEV-ALF患者血清外泌体来源的ALDH1A1水平显著高于AHE患者和健康对照组（P均< 0.05）。此外，血清外泌体来源的ALDH1A1水平在三器官以上衰竭组最高，其次是三器官衰竭组和两器官衰竭组（均P < 0.001）。此外，HEV-ALF患者血清外泌体来源的ALDH1A1与总胆红素呈正相关（r = 0.315, P < 0.001）。血清外泌体来源的ALDH1A1水平在治疗反应中的比较显示，改善组血清外泌体来源的ALDH1A1水平降低，而波动组和恶化组血清外泌体来源的ALDH1A1水平升高（均P < 0.001）。此外，血清外泌体来源的ALDH1A1是预测30天死亡率的独立危险因素（P < 0.001）。受试者工作特征曲线下面积为0.943，灵敏度为94.87 %，特异度为87.72 %，具有较强的决策能力。然而，年龄< 60岁和≥60岁的患者血清外泌体来源的ALDH1A1水平无显著差异（P = 0.131）。结论：血清外泌体来源的ALDH1A1对HEV-ALF患者的预后有很大的预测作用。

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来源期刊

Hepatobiliary & Pancreatic Diseases International 医学-胃肠肝病学

CiteScore

5.40

自引率

6.10%

发文量

152

审稿时长

3.0 months

期刊介绍： Hepatobiliary & Pancreatic Diseases International (HBPD INT) (ISSN 1499-3872 / CN 33-1391/R) a bimonthly journal published by First Affiliated Hospital, Zhejiang University School of Medicine, China. It publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatobiliary and pancreatic diseases. Papers cover the medical, surgical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas under the headings Liver, Biliary, Pancreas, Transplantation, Research, Special Reports, Editorials, Review Articles, Brief Communications, Clinical Summary, Clinical Images and Case Reports. It also deals with the basic sciences and experimental work. The journal is abstracted and indexed in SCI-E, IM/MEDLINE, EMBASE/EM, CA, Scopus, ScienceDirect, etc.