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Matiollo C, Rateke ECDM, Moura EQDA, Andrigueti M, Augustinho FCD, Zocche TL, Silva TE, Gomes LO, Farias MR, Narciso-Schiavon JL, Schiavon LL. Elevated calprotectin levels are associated with mortality in patients with acute decompensation of liver cirrhosis. World J Hepatol 2022; 14:1964-1976. [PMID: 36483607 PMCID: PMC9724106 DOI: 10.4254/wjh.v14.i11.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acute decompensation (AD) of cirrhosis is related to systemic inflammation and elevated circulating cytokines. In this context, biomarkers of inflammation, such as calprotectin, may be of prognostic value.
AIM To evaluate serum calprotectin levels in patients hospitalized for complications of cirrhosis.
METHODS This is a prospective cohort study that included 200 subjects hospitalized for complications of cirrhosis, 20 outpatients with stable cirrhosis, and 20 healthy controls. Serum calprotectin was measured by enzyme-linked immunosorbant assay.
RESULTS Calprotectin levels were higher among groups with cirrhosis when compared to healthy controls. Higher median calprotectin was related to Child-Pugh C, ascites, and hepatic encephalopathy. Higher calprotectin was related to acute-on-chronic liver failure (ACLF) and infection in the bivariate, but not in multivariate analysis. Calprotectin was not associated with survival among patients with ACLF; however, in patients with AD without ACLF, higher calprotectin was associated with a lower 30-d survival, even after adjustment for chronic liver failure-consortium (CLIF-C) AD score. A high-risk group (CLIF-C AD score ≥ 60 and calprotectin ≥ 580 ng/mL) was identified, which had a 30-d survival (27.3%) similar to that of patients with grade 3 ACLF (23.3%).
CONCLUSION Serum calprotectin is associated with prognosis in patients with AD without ACLF and may be useful in clinical practice to early identify patients with a very low short-term survival.
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Affiliation(s)
- Camila Matiollo
- Clinical Analysis Laboratory Unit, University Hospital, Federal University of Santa Catarina, Florianopolis 88040-900, Brazil
| | | | | | - Michelle Andrigueti
- Clinical Analysis Laboratory Unit, University Hospital, Federal University of Santa Catarina, Florianopolis 88040-900, Brazil
| | | | - Tamara Liana Zocche
- Division of Gastroenterology, University Hospital, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Telma Erotides Silva
- Division of Gastroenterology, University Hospital, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Lenyta Oliveira Gomes
- Department of Pharmaceutical Sciences Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-370, Brazil
| | - Mareni Rocha Farias
- Department of Pharmaceutical Sciences Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-370, Brazil
| | - Janaina Luz Narciso-Schiavon
- Division of Gastroenterology, Department of Internal Medicine, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil
| | - Leonardo Lucca Schiavon
- Division of Gastroenterology, Department of Internal Medicine, Federal University of Santa Catarina, Florianopolis 88040-900, SC, Brazil
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Cisilotto J, do Amaral AE, Rosolen D, Rode MP, Silva AH, Winter E, da Silva TE, Fischer J, Matiollo C, Rateke ECDM, Narciso-Schiavon JL, Schiavon LDL, Creczynski-Pasa TB. MicroRNA profiles in serum samples from Acute-On-Chronic Liver Failure patients and miR-25-3p as a potential biomarker for survival prediction. Sci Rep 2020; 10:100. [PMID: 31919459 PMCID: PMC6952390 DOI: 10.1038/s41598-019-56630-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022] Open
Abstract
Acute-on-chronic liver failure (ACLF) is a condition characterized by acute decompensation of cirrhosis, associated with organ failure(s), and high short-term mortality. The microRNAs or miRNAs are small non-coding RNA molecules, stable in circulating samples such as biological fluids, and the difference in expression levels may indicate the presence, absence and/or stage of the disease. We analyzed here the miRNA profiling to identify potential diagnostic or prognostic biomarkers for ACLF. The major miRNAs discovered were validated in a cohort of patients with acute decompensation of cirrhosis grouped in no ACLF or ACLF according to EASL-CLIF definition. Relationship between serum miRNAs and variables associated with liver-damage and survival outcomes were verified to identify possible prognostic markers. Our results showed twenty altered miRNAs between no ACLF and ACLF patients, and twenty-seven in patients who died in 30 days compared with who survived. In validation phase, miR-223-3p and miR-25-3p were significantly altered in ACLF patients and in those who died in 30 days. miR-223-3p and miR-25-3p expression were associated with the lowest survival in 30 days. The decrease in miR-223-3p and miR-25-3p expression was associated with the presence of ACLF and poor prognosis. Of these, miR-25-3p was independently related to ACLF and 30-day mortality.
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Affiliation(s)
- Júlia Cisilotto
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, 88040-900, SC, Brazil
| | - Alex Evangelista do Amaral
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, 88040-900, SC, Brazil
| | - Daiane Rosolen
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, 88040-900, SC, Brazil
| | - Michele Patrícia Rode
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianopolis, 88040-900, SC, Brazil
| | - Adny Henrique Silva
- Department of Biochemistry, Federal University of Santa Catarina, Florianopolis, 88040-900, SC, Brazil
| | - Evelyn Winter
- Department of Agriculture, Biodiversity and Forestry, Federal University of Santa Catarina, Curitibanos, 89520-000, SC, Brazil
| | - Telma Erotides da Silva
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil
| | - Josiane Fischer
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil
| | - Camila Matiollo
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil
| | - Elayne Cristina de Morais Rateke
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil
| | - Janaína Luz Narciso-Schiavon
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil
| | - Leonardo de Lucca Schiavon
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Florianópolis, 88040-900, SC, Brazil.
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Amaral AED, Rode MP, Cisilotto J, Silva TED, Fischer J, Matiollo C, Morais Rateke ECD, Narciso-Schiavon JL, Schiavon LL, Creczynski-Pasa TB. MicroRNA profiles in serum samples from patients with stable cirrhosis and miRNA-21 as a predictor of transplant-free survival. Pharmacol Res 2018; 134:179-192. [PMID: 29935272 DOI: 10.1016/j.phrs.2018.06.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 12/19/2022]
Abstract
MicroRNAs (miRNAs) have remarkable potential as diagnostic and prognostic markers because of their roles in disease pathogenesis. miRNAs can be released into the bloodstream, where they are sufficiently stable to be detected noninvasively. Here, we prospectively evaluated serum levels of miR-21, miR-34a, miR-122, miR-181b, and miR-885-5p in patients with stable cirrhosis. Total RNA was extracted from the sera of patients with cirrhosis and healthy individuals, and the expression levels of the target miRNAs were analyzed by reverse transcription-quantitative polymerase chain reaction. Serum miRNAs levels were correlated with liver function parameters, etiology, and complications of cirrhosis. Circulating miR-34a, miR-122, and miR-885-5p levels were higher in patients with cirrhosis than in healthy individuals. These miRNAs were positively correlated with alanine aminotransferase and aspartate aminotransferase levels, and the relative expression levels were higher in hepatitis C virus-infected patients and lower in patients with Child-Pugh C cirrhosis. miR-122 and miR-885-5p levels were also positively correlated with γ-glutamyl transpeptidase concentrations. miR-21 was associated with transplant-free survival in univariate Cox regression analysis and remained independently associated with survival after adjustment for age, Child-Pugh classification, Model for End-stage Liver Disease score, and history of previous decompensation in multivariate Cox regression analysis. These data suggested that miR-34a, miR-122, and miR-885-5p levels may be more related to the inflammatory process and ongoing hepatocyte damage in patients with cirrhosis. Moreover, miR-21 levels were independently associated with shorter transplant-free survival and may be used as a prognostic tool in outpatients with stable cirrhosis.
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Affiliation(s)
- Alex Evangelista do Amaral
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Delfino Conti Street, Florianopolis 88040-370, SC, Brazil.
| | - Michele Patrícia Rode
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Delfino Conti Street, Florianopolis 88040-370, SC, Brazil.
| | - Julia Cisilotto
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Delfino Conti Street, Florianopolis 88040-370, SC, Brazil.
| | - Telma Erotides da Silva
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil.
| | - Josiane Fischer
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil.
| | - Camila Matiollo
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil.
| | - Elayne Cristina de Morais Rateke
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil.
| | - Janaína Luz Narciso-Schiavon
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil
| | - Leonardo Lucca Schiavon
- Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Maria Flora Pausewang Street, Florianopolis 88036-800, SC, Brazil.
| | - Tânia Beatriz Creczynski-Pasa
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Delfino Conti Street, Florianopolis 88040-370, SC, Brazil.
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