Oliver Waidmann1, Friederike Brunner2, Eva Herrmann3, Stefan Zeuzem2, Albrecht Piiper2, Bernd Kronenberger2. 1. Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany. waidmann@biochem2.uni-frankfurt.de. 2. Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany. 3. Institut für Biostatistik und Mathematische Modellierung, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany.
Abstract
BACKGROUND & AIMS: Hepatocyte death is an important factor in development and progression of cirrhosis. Cytokeratin 18-based serum markers reflecting apoptotic (M30) and overall epithelial cell death (M65 and M65EpiDeath) have been used as prognostic parameters for survival in patients with acute liver failure. However, there has been no trial investigating M30, M65 and M65EpiDeath as survival parameters in patients with cirrhosis and acute-on-chronic liver failure. METHODS: Patients with cirrhosis were enrolled and followed until death, liver transplantation or last contact. M30, M65 and M65EpiDeath serum levels were quantified in patient's sera. RESULTS: Three hundred and thirty-one patients were screened and 211 patients could be included in this study. The median duration of follow-up was 322 days with a range of 1-1382 days. All three cell death parameters correlated with the extent of the severity of the disease. However, M65EpiDeath was the only of the three parameters which was associated with the severe complications of cirrhosis including ascites, spontaneous bacterial peritonitis and hepatorenal syndrome. Additionally, M65EpiDeath was the only cell death parameter which was independently from liver function and its surrogate parameter such as Child-Pugh score and the model of end-stage liver disease associated with overall survival. CONCLUSIONS: Epithelial cell death reflected by M65EpiDeath serum levels is an indicator for the severity of cirrhosis and a prognostic survival parameter in cirrhotic patients.
BACKGROUND & AIMS: Hepatocyte death is an important factor in development and progression of cirrhosis. Cytokeratin 18-based serum markers reflecting apoptotic (M30) and overall epithelial cell death (M65 and M65EpiDeath) have been used as prognostic parameters for survival in patients with acute liver failure. However, there has been no trial investigating M30, M65 and M65EpiDeath as survival parameters in patients with cirrhosis and acute-on-chronic liver failure. METHODS:Patients with cirrhosis were enrolled and followed until death, liver transplantation or last contact. M30, M65 and M65EpiDeath serum levels were quantified in patient's sera. RESULTS: Three hundred and thirty-one patients were screened and 211 patients could be included in this study. The median duration of follow-up was 322 days with a range of 1-1382 days. All three cell death parameters correlated with the extent of the severity of the disease. However, M65EpiDeath was the only of the three parameters which was associated with the severe complications of cirrhosis including ascites, spontaneous bacterial peritonitis and hepatorenal syndrome. Additionally, M65EpiDeath was the only cell death parameter which was independently from liver function and its surrogate parameter such as Child-Pugh score and the model of end-stage liver disease associated with overall survival. CONCLUSIONS: Epithelial cell death reflected by M65EpiDeath serum levels is an indicator for the severity of cirrhosis and a prognostic survival parameter in cirrhotic patients.
Authors: Hani Oweira; Mahmoud Sadeghi; Daniel Volker; Markus Mieth; Ahmed Zidan; Elias Khajeh; Omid Ghamarnejad; Hamidreza Fonouni; Karl Heinz Weiss; Jan Schmidt; Imad Lahdou; Arianeb Mehrabi Journal: Ann Transplant Date: 2018-06-08 Impact factor: 1.530
Authors: Fabian Finkelmeier; Özge Canli; Kai-Henrik Peiffer; Dirk Walter; Andrea Tal; Christine Koch; Ursula Pession; Johannes Vermehren; Jörg Trojan; Stefan Zeuzem; Albrecht Piiper; Florian R Greten; Georgios Grammatikos; Oliver Waidmann Journal: PLoS One Date: 2018-07-16 Impact factor: 3.240
Authors: Gersina Rega-Kaun; Dorothea Ritzel; Christoph Kaun; Benjamin Ebenbauer; Barbara Thaler; Manfred Prager; Svitlana Demyanets; Johann Wojta; Philipp J Hohensinner Journal: Int J Mol Sci Date: 2019-04-30 Impact factor: 5.923