Journal
BMC GASTROENTEROLOGY
Volume 19, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12876-019-1064-3
Keywords
Chronic hepatitis B; Acute-on-chronic liver failure; Inflammation; Biomarkers
Categories
Funding
- National Natural Science Foundation of China [81770611]
- Natural Science Foundation of Beijing [7162085]
- Applied Research for the Clinical Characteristics of Capital [Z121107001012167]
- High-level Technical Personnel Training Plan of the Beijing Health System [2013-3-075, 2015-3-099]
- Tian qing liver disease foundation of CFHPC [TQGB20180213]
- National 135 Major Project of China [2018ZX103002205-004-004, 2018ZX10301407-005-002]
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Background Caspase-1 is an evolutionarily conserved enzyme that proteolytically cleaves the precursors of the inflammatory cytokines interleukin 1 beta and interleukin 18. However, the role of caspase-1 in determining the severity of acute-on-chronic liver failure (ACLF) has yet to be elucidated. We evaluated the expression levels of caspase-1 in HBV-related liver disease and assessed its utility as a biomarker predicting the severity of ACLF. Methods The gene, protein and activity levels of caspase-1 were measured in the liver and/or serum of subjects with HBV-related disease. We also analysed the correlation between the expression levels of caspase-1 and liver injury of ACLF. Results Compared with the values observed in normal subjects, the relative caspase-1 mRNA and protein levels in livers were decreased in patients with CHB, LC, and HCC but increased in those with ACLF; moreover, ACLF patients had the lowest serum level and hepatic activity of caspase-1 among the five groups. The serum caspase-1 levels in ACLF patients showed a negative correlation with total serum bilirubin and a positive correlation with serum total protein and albumin. Importantly, the serum caspase-1 levels in the surviving group with ACLF were higher than those in the non-surviving group and showed different dynamic trends. Analyses of the area under the receiver operating characteristic curve indicated that caspase-1 (AUC = 0.84, AUC of MELD score = 0.72) may be a useful marker for independently predicting ACLF. Conclusion Caspase-1 is a potential non-invasive biomarker of disease progression and prognosis in ACLF.
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