Serum human epididymis protein 4 levels in patients with autoimmune hepatitis and its association with disease severity and liver fibrosis

Abstract

Abstract: Objective To investigate the changes in serum human epididymis protein 4 (HE4) levels in patients with autoimmune hepatitis (AIH), and to analyze the correlation between HE4 levels and disease severity as well as liver fibrosis stage. This study aims to evaluate the potential clinical value of HE4 in the diagnosis and management of AIH, thereby providing new insights and a theoretical basis for individualized treatment and disease monitoring in AIH. Methods A total of 77 AIH patients who were diagnosed and treated at our hospital between June 2020 and December 2024 were enrolled. Serum HE4 levels were compared among patients with different disease severity, histological inflammation grades, and fibrosis stages. The diagnostic performance of HE4 for predicting disease severity, hepatic inflammation, and liver fibrosis was assessed. Results According to severity classification, serum levels of ALT, AST, TBil, and HE4 in severe AIH patients were 137 (108, 211) U/L, 146 (112, 194) U/L, 91.5 (68.0, 117.4) μmol/L, and 78.6 (54.5, 90.2) pmol/L, respectively, significantly higher than those in mild-to-moderate patients [77 (55, 91) U/L, 65 (50, 85) U/L, 27.7 (19.8, 36.5) μmol/L, and 50.7 (36.6, 68.0) pmol/L, P<0.05]. Conversely, the Alb level was (36.4±1.8) g/L, significantly lower than that in mild-to-moderate patients [(41.0±2.6) g/L, P<0.05]. Patients with a higher histological inflammation grade or liver fibrosis stage had significantly higher HE4 levels compared to those with milder grades or stages, with statistically significant differences (P<0.05). HE4 demonstrated high efficacy in predicting different severity levels, histological inflammation grades, and liver fibrosis stages in AIH patients, with diagnostic AUC values all exceeding 0.80. Conclusion Serum HE4 levels are significantly elevated in AIH patients and closely associated with disease severity, histological inflammatory activity, and the extent of liver fibrosis. HE4 may serve as a potential non-invasive biomarker to aid in the assessment of disease activity and liver tissue injury in AIH, showing promising diagnostic value and clinical application potential.

Key words: Autoimmune hepatitis, Human epididymis protein 4, Histological inflammatory activity, Liver fibrosis

ZHANG Ling, CHENG Wan-qian, LIN Ling. Serum human epididymis protein 4 levels in patients with autoimmune hepatitis and its association with disease severity and liver fibrosis[J]. Chinese Hepatolgy, 2026, 31(1): 68-70.

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