神经丝蛋白轻链而非胶质纤维酸性蛋白是肝硬化患者明显肝性脑病的潜在生物标志物。

IF 3.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Annals of hepatology Pub Date : 2024-03-07 DOI:10.1016/j.aohep.2024.101496
Koos de Wit , Diederick J. van Doorn , Bregje Mol , Lonneke A. van Vught , Frederik Nevens , Ulrich Beuers , Cyriel Y. Ponsioen , Charlotte E. Teunissen , R. Bart Takkenberg
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引用次数: 0

摘要

引言和目的:肝性脑病(HE)是肝硬化的常见并发症,可造成脑损伤。神经退行性疾病可诱导神经丝蛋白轻链(NfL)和神经胶质纤维酸性蛋白(GFAP)等神经蛋白在包括血浆在内的体液中释放。我们研究了 NfL 和 GFAP 是否可作为显性高血压(oHE)的潜在诊断血浆生物标记物:我们纳入了来自三个前瞻性队列的 85 名患者,他们的肝病和 HE 严重程度各不相同。纳入的患者如下:1)34 例原发性硬化性胆管炎(PSC)代偿期患者。2)17 名晚期肝病患者,在选择性经颈静脉肝内门体系统分流术(TIPS)之前没有出现 oHE;3)17 名重症监护病房(ICU)患者出现 oHE,17 名重症监护病房患者没有肝硬化或 oHE。采用单分子测定法测量血浆NfL和GFAP:结果:与TIPS前患者或ICU对照组相比,ICU oHE患者的NfL浓度更高(p):血浆 NfL 作为 oHE 的潜在诊断生物标志物值得进一步评估,它与 MELD 评分相关。
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Neurofilament light chain but not glial fibrillary acidic protein is a potential biomarker of overt hepatic encephalopathy in patients with cirrhosis

Introduction and Objectives

Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and may cause cerebral damage. Neurodegenerative diseases can induce the release of neuroproteins like neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in body fluids, including blood plasma. We investigated whether NfL and GFAP could serve as potential diagnostic plasma biomarkers for overt HE (oHE).

Materials and Methods

We included 85 patients from three prospective cohorts with different stages of liver disease and HE severity. The following patients were included: 1) 34 patients with primary sclerosing cholangitis (PSC) with compensated disease; 2) 17 patients with advanced liver disease without oHE before elective transjugular intrahepatic portosystemic shunt (TIPS) placement; 3) 17 intensive care unit (ICU) patients with oHE and 17 ICU patients without cirrhosis or oHE. Plasma NfL and GFAP were measured using single molecule assays.

Results

ICU oHE patients had higher NfL concentrations compared to pre-TIPS patients or ICU controls (p < 0.05, each). Median GFAP concentrations were equal in the ICU oHE and pre-TIPS patients or ICU controls. Plasma NfL and GFAP concentrations correlated with Model for End-Stage Liver Disease (MELD) scores (R = 0.58 and R = 0.40, p < 0.001, each).

Conclusions

Plasma NfL deserves further evaluation as potential diagnostic biomarker for oHE and correlates with the MELD score.

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来源期刊
Annals of hepatology
Annals of hepatology 医学-胃肠肝病学
CiteScore
7.90
自引率
2.60%
发文量
183
审稿时长
4-8 weeks
期刊介绍: Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.
期刊最新文献
Editorial board Global multi-societies endorsement of the MAFLD definition An Acknowledgement Biological aging accelerates hepatic fibrosis: Insights from the NHANES 2017-2020 and genome-wide association study analysis. Development of a biodegradable prosthesis through tissue engineering, for the organ-replacement or substitution of the extrahepatic bile duct
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