期刊
JOURNAL OF MEDICAL VIROLOGY
卷 94, 期 10, 页码 5015-5025出版社
WILEY
DOI: 10.1002/jmv.27961
关键词
carbamoyl phosphate synthase 1 (CPS1); diagnosis; exosomes; HEV-related acute liver failure (HEV-ALF); prognosis
类别
资金
- major national science and technology projects on infectious diseases [81790630]
This study found that serum exosome-derived CPS1 levels were significantly elevated in HEV-ALF patients and were closely associated with organ failure and prognosis. Serum exosome-derived CPS1 levels may serve as a promising diagnostic and prognostic biomarker for HEV-ALF patients.
Early diagnosis and prognosis evaluation are of great significance to hepatitis E virus (HEV)-related acute liver failure (HEV-ALF) patients. We collected serum samples from 200 health controls (HCs), 200 patients with acute hepatitis E (AHE), and 200 HEV-ALF patients to evaluate serum exosome-derived carbamoyl phosphate synthase 1 (CPS1) levels and determine its diagnostic and prognostic value. The exosome-derived CPS1 levels in the HEV-ALF group were significantly higher than those in the AHE and HCs groups. The AUC of exosome-derived CPS1 to predict the occurrence of HEV-ALF was 0.850 (0.811-0.883). Both logistical regression and orthogonal partial least squares discriminant analysis (OPLS-DA) showed that exosome-derived CPS1 is an independent risk factor for HEV-ALF. The exosome-derived CPS1 levels were positively correlated with organ failure and the outcomes in HEV-ALF patients. The exosome-derived CPS1 levels in the worsening group were significantly higher than those in the fluctuating and the improving groups. The AUC of serum exosome-derived CPS1 to predict 30-day mortality was 0.829 (0.770-0.879), which was significantly greater than that of the Child-Pugh, KCH, and MELD models. The level of serum exosome-derived CPS1 might serve as a promising diagnostic and prognostic biomarker for HEV-ALF patients, which may provide better guidance for the diagnosis, prognosis, and treatment of HEV-ALF patients.
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