The diagnostic value of serum Cat S level in patients with primary biliary cholangitis

Abstract

Abstract: Objective To investigate the changes and diagnostic value of serum cathepsin S (Cat S) level in patients with primary biliary cholangitis (PBC). Methods A total of 135 patients with PBC and hepatitis B (HBV) who were admitted from June 2017 to October 2020 were selected and denoted as PBC group (75 cases) and HBV group (60 cases), respectively. The serum levels of total Cat S, pro-Cat S and active-Cat S were compared between the two groups of patients. Pearson correlation analysis was used to explore the correlation between serum Cat S and alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), immunoglobulin G (IgG) and immunoglobulin M (IgM) in PBC patients. Rreceiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was used to evaluate the diagnostic value of serum Cat S for PBC. Results The levels of ALP, GGT, IgG and IgM in the PBC group were (258.76±82.56) U/L, (258.76±82.56) U/L, (258.76±82.56) g/L, and (258.76±82.56) g/L, respectively,which were all higher than those of [(187.52±64.38), (215.33±76.21), (8.32±2.45), (2.53±1.05)] in the HBV group (t=14.310, 9.713, 8.016; all P<0.05). Similarly,serum levels of total Cat S, pro-Cat S and active-Cat S in the PBC group were (14.85±4.52) pg/L, (8.53±3.61) pg/L, and (6.32±1.87) pg/L, respectively, which were higher than those of [(5.26±2.85) pg/L, (3.82±1.15) pg/L, (1.44±0.75) pg/L] in the HBV group (t=5.481, 8.078, 10.098, 6.668; all P<0.05). Serum total Cat S level in PBC patients was positively correlated with ALP, GGT, IgG and IgM (r=0.625, 0.581, 0.681, 0.582, P<0.05). Concordancely, serum pro-Cat S level was positively correlated with ALP, GGT, IgG and IgM (r=0.764, 0.676, 0.753, 0.603, P<0.05). By ROC analysis it was shown that the best cut-off points for the diagnosis of PBC by serum total Cat S, pro-Cat S and active-Cat S were 8.79 pg/L, 5.88 pg/L, 3.16 pg/L, and the AUCs were 0.887, 0.644, 0.658, respectively. Conclusion The level of serum Cat S in patients with PBC is abnormally increased, and its diagnostic efficiency for PBC is high. Serum level of Cat S can be used as an important reference index for the diagnosis of PBC.

Key words: Primary biliary cholangitis, Serum cathepsin S, Cholestasis, Diagnosis

GAO Lin-lin, KONG Mi-cai, FENG Wei-hua. The diagnostic value of serum Cat S level in patients with primary biliary cholangitis[J]. Chinese Hepatolgy, 2022, 27(5): 570-572.

References

[1] Gulamhusein AF, Hirschfield GM. Primary biliary cholangitis: pathogenesis and therapeutic opportunities. Nat Rev Gastroenterol Hepatol, 2020, 17(2):93-110.
[2] Gonzalez RS, Washington K. Primary biliary cholangitis and autoimmune hepatitis. Surg Pathol Clin, 2018, 11(2):329-349.
[3] Shah RA, Kowdley KV. Current and potential treatments for primary biliary cholangitis. Lancet Gastroenterol Hepatol, 2020, 5(3):306-315.
[4] Huang S, Cao Y. Correlation of cathepsin S with coronary stenosis degree, carotid thickness, blood pressure, glucose and lipid metabolism and vascular endothelial function in atherosclerosis. Exp Ther Med, 2020,19(1):61-66.
[5] Chen L, Lu B, Yang Y, et al. Elevated circulating cathepsin S levels are associated with metabolic syndrome in overweight and obese individuals. Diabetes Metab Res Rev, 2019,35(3):117-119.
[6] 贾继东. 原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015). 肝脏, 2015, 20(12):960-968.
[7] 王贵强, 王福生, 成军, 等. 慢性乙型肝炎防治指南(2015年版). 实用肝脏病杂志, 2016, 19(3):389-400.
[8] Younossi ZM, Bernstein D, Shiffman ML, et al. Diagnosis and management of primary biliary cholangitis. Am J Gastroenterol, 2019, 114(1):48-63.
[9] Lleo A, Leung PSC, Hirschfield GM, et al. The pathogenesis of primary biliary cholangitis: a comprehensive review. Semin Liver Dis, 2020, 40(1):34-48.
[10] Corpechot C, Chazouillères O, Rousseau A, et al. A placebo-controlled trial of bezafibrate in primary biliary cholangitis. N Engl J Med, 2018, 378(23):2171-2181.
[11] Hirschfield GM, Beuers U, Kupcinskas L, et al. A placebo-controlled randomised trial of budesonide for PBC following an insufficient response to UDCA. J Hepatol, 2021, 74(2):321-329.
[12] 丁慧红, 杨一, 谢晓君, 等. 血清PA、TBA、GGT和ALP联合检测对肝脏疾病诊断的临床意义分析. 重庆医学, 2018, 47(12):1691-1693+1695.
[13] Lee BT, Wang Y, Yang A, et al. IgG:IgM ratios of liver plasma cells reveal similar phenotypes of primary biliary cholangitis with and without features of autoimmune hepatitis. Clin Gastroenterol Hepatol, 2021, 19(2):397-399.
[14] Feng L, Dong K, Zhang X, et al. Clinical significance of IgG antimitochondrial M2 antibody levels in primary biliary cholangitis: a single center study from china. PLoS One, 2020, 15(11):164-168.
[15] Ronca V, Chen QB, Lygoura V, et al. Autoantibodies in patients with interleukin 12 receptor beta 1 deficiency. J Dig Dis, 2019, 20(7):363-370.
[16] 靳睿, 王晓晓, 王力华, 等. 抗线粒体抗体与原发性胆汁性胆管炎临床血清学和肝硬化指标的相关性. 中华消化杂志, 2020, 40(1):16-22.
[17] Ariyoshi Y, Takeuchi K, Pomposelli T, et al. Antibody reactivity with new antigens revealed in multi-transgenic triple knockout pigs may cause early loss of pig kidneys in baboons. Xenotransplantation, 2021, 28(1):42-48.
[18] 李艳艳, 高润平. IgM反应是熊去氧胆酸和苯扎贝特治疗原发性胆汁性胆管炎的预后生物标志物. 临床肝胆病杂志, 2020, 18(3):601-603.
[19] Zhang AW, Han XS, Xu XT, et al. Acute phase serum cathepsin S level and cathepsin S/cystatin C ratio are the associated factors with cerebral infarction and their diagnostic value for cerebral infarction. Kaohsiung J Med Sci, 2019, 35(2):95-101.
[20] Toyama S, Yamashita T, Saigusa R, et al. Decreased serum cathepsin S levels in patients with systemic sclerosis-associated interstitial lung disease. J Dermatol, 2020, 47(9):1027-1032.
[21] 罗璇, 李霞, 杜志荣, 等. 组织蛋白酶S在原发性胆汁性胆管炎中作用的研究. 中华医学杂志, 2019, 99(7):505-509.
[22] 梁艳, 秦保东, 史虹, 等. 原发性胆汁性胆管炎患者血清游离TAM受体家族分子的水平及临床意义. 临床检验杂志, 2018, 36(10):729-731.