Table of Content

30 September 2019, Volume 24 Issue 9

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Original Articles

Study of risk factors and high-risk population of acute kidney injury in patients with hepatitis B virus related acute on chronic liver failure

ZHANG Zhi-qiao, YE Yi-nong, HE Gang, WANG Peng, LI Jing, WU Xing-liu

2019, 24(9):  997-1001. 

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Objective To investigate the risk factors and high-risk population of acute kidney injury (AKI) in patients with hepatitis B virus related acute on chronic liver failure (HBV-ACLF) by classification tree method, and to establish a simple method for evaluating the risk of AKI in patients with HBV-ACLF.Methods The clinical data of patients with HBV-ACLF hospitalized in the Department of Infectious Diseases from 3 hospitals including the First People's Hospital of Foshan, Jiangmen Central Hospital and Shunde Hospital of Southern Medical University from January 2010 to June 2018 were collected and analyzed. The risk factors and high-risk population of AKI were investigated by classification tree method.Results The model for end-stage liver disease (MELD) score and age in AKI group were significantly higher than those in non-AKI group (31.6±9.0 vs 21.5±6.1, 51.0±14.3 vs 44.1±13.0), with significant difference (P<0.05). Multivariate logistic regression analysis suggested that MELD score (odds ratio [OR]=1.209, 95% confidence interval [CI]: 1.141-1.281) and age (OR=1.042, 95%CI: 1.012-1.072) were independent factors of AKI in patients with HBV-ACLF. The classification tree model suggested that the factors affecting AKI in patients with HBV-ACLF include MELD score and age. The total agreement rate of the classification tree model based on MELD score and age was 0.873, indicating that the classification tree model had a better fitting effect.Conclusion AKI in patients with HBV-ACLF is related to MELD score and age. And a simple classification tree model based on MELD score and age can be used to assess the risk of AKI in patients with HBV-ACLF.

Combination of hepatitis B core antibody and early virological response for predicting serological response in hepatitis B patients receiving peginterferon

WANG Qian-qian, HU Qian-kun, ZHANG Yi, FANG Zhong, HUANG Chen-lu, XU Wei, CHEN Liang, HUANG Yu-xian

2019, 24(9):  1002-1006. 

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Objective To investigate the value of semi-quantitative detection of hepatitis B core antibody (HBcAb) combined with early virological response in predicting hepatitis B envelope antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B (CHB) patients treated with peginterferon initially.Methods A total of 96 HBeAg-positive CHB patients in our hospital from January 2013 to January 2019 were retrospectively analyzed. All patients were initially treated with peginterferon for 48 weeks. The level of HBcAb was measured by chemiluminescent microparticle immunoassay before and during treatment every 12 weeks. Mann-Whitney U test and Kruskal-Wallis H test were used to determine intergroup differences. Receiver operating characteristic (ROC) curve was used to calculate the diagnostic value.Results Baseline HBcAb levels of patients who achieved serological response were higher (11.92, 10.07-12.80 vs 10.61, 9.49-11.47, P=0.003). Univariate logistic regression analysis showed that baseline HBcAb level (odds ratio [OR]=1.469, 95% confidence interval: 1.137-1.898, P=0.003) and achievement of early virological response (OR=3.507, 95% CI: 1.051-11.69, P=0.041) were independently related to serological response of peginterferon. Multivariate binary logistic regression analysis suggested that baseline HBcAb level (OR=1.831, 95% CI: 1.299-2.582, P=0.001) and early virological response (OR=2.161, 95% CI: 1.595-7.851, P=0.024) could predict serological response in CHB patients receiving peginterferon. The cut-off value of baseline HBcAb was 11.6 S/CO with the area under the ROC curve of 0.72 (95% CI: 0.59-0.86, P=0.004), and the diagnostic sensitivity and specificity were 73.42% and 64.71%, respectively. Patients were stratified according to the baseline HBcAb cut-off value of 11.6 S/CO and the achievement of early virological response. The HBeAg seroconversion rate at week 48 of patients who achieved early virological response with baseline HBcAb ≥ 11.6 S/CO was 42.86%. The HBeAg seroconversion rates at week 48 of patients with either baseline HBcAb ≥ 11.6 S/CO or early virological response were 18.18% (2/11) and 12.12% (4/33). And only 0.06% (2/31) achieved HBeAg seroconversion among patients with baseline HBcAb < 11.6 S/CO and without early virological response.Conclusion The semi-quantitative detection of baseline HBcAb combined with early virological response may serve as a simple and valuable predictor of serological response in HBeAg-positive CHB patients receiving peginterferon initially, guiding physicians in clinical practice.

Ox-LDL-induced ETs production of macrophages in patients with cirrhosis

MENG Qing-yang, XU Chun-lin, KANG Peng

2019, 24(9):  1007-1010. 

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Objective To investigate whether the oxidized low-density lipoprotein (ox-LDL) in cirrhosis patients induces macrophages to release extracellular traps (ETs) and promotes the development of cirrhosis.Methods Liver ultrasound and transient elastography were used to screen patients with cirrhosis. The formation of ETs was observed by stimulating macrophages with ox-LDL and other substances. Ox-LDL and ETs levels were detected. Phenotype transformation of macrophages was induced.Results Macrophages in healthy people did not release ETs with the stimulation of ox-LDL. Conversely, the ETs formation of macrophages in patients with cirrhosis was induced by the stimulation of ox-LDL, which reached its peak at 5 hours after stimulation. ETs induced the transformation of macrophages from phenotype M1 to M2.Conclusion Ox-LDL can induce macrophages to produce ETs in patients with cirrhosis, which may be related to the development mechanism of cirrhosis.

SB-525334 downregulates the expression of miR-19b and miR-29b in hepatic stellate cells

WU Jiang-hua, MA Jun-Ji, GUO Yu, GUO Ping

2019, 24(9):  1011-1014. 

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Objective The hepatic stellate cell line LX-2 was selected to study the effect of SB-525334 on the secretion of type I collagen and the expression of micro-ribonucleic acid (miR)-19b and miR-29b after stimulation by transforming growth factor beta1 (TGF-β1), so as to evaluate the value of SB-525334 in the prevention and treatment of hepatic fibrosis.Methods Methyl thiazolyl tetrazolium (MTT) method was used to detect the optimal concentration and time of TGF-β1 and SB-525334 interfering with LX-2 cells. Then the LX-2 cells were divided into 4 groups, the control group, the TGF-β1 intervention group, the SB-525334 intervention group, and the co-intervention group. The expression of type I collagen, miR-19b and miR-29b was analyzed by western blot and reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR).Results Hepatic stellate cell MTT test showed that the highest survival rate was 132.0% when the concentration of TGF-β1 was 10 ng/mL. When the concentration of SB-525334 was 10 μmol/L, the inhibition rate was 38.4%. Western blot showed that SB-525334 inhibited type I collagen expression in LX-2 cells. The type I collagen expression of LX-2 cells in TGF-β1 intervention group was significantly higher than that in the control group ([82.80±4.39]% vs [17.89±4.27]%, P<0.01). The type I collagen expression of LX-2 cells in co-intervention group was lower than that in TGF-β1 intervention group ([62.62±3.72)% vs [82.80±4.39]%, P<0.05). RT-qPCR showed that SB-525334 downregulated miR-19b expression in LX-2 cells. The relative miR-19b expression of LX-2 cells in TGF-β1 intervention group, SB-525334 intervention group, and co-intervention group (0.62±0.07, 0.28±0.06, 0.64±0.20) was significantly lower than that in the control group (P<0.01). The relative miR-19b expression of LX-2 cells in co-intervention group was higher than that in SB-525334 group (P<0.05). There was no significant difference in the relative miR-19b expression of LX-2 cells between co-intervention and TGF-β1 intervention groups (P>0.05). Besides, SB-525334 downregulated miR-29b expression in LX-2 cells. The relative miR-29b expression of LX-2 cells in TGF-β1 intervention group, SB-525334 intervention group, and co-intervention group (0.77±0.05, 0.44±0.04, 0.61±0.06) was significantly lower than that in the control group (P<0.05). The relative miR-29b expression of LX-2 cells in co-intervention group was lower than that in TGF-β1 group (P<0.05). The relative miR-29b expression of LX-2 cells in co-intervention group was higher than that in SB-525334 group (P<0.05).Conclusion TGF-β1 inhibitor SB-525334 inhibited the secretion of type I collagen as well as downregulated the expression of miR-19b and miR-29b in hepatic stellate cells.