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Soluble Programmed Cell Death 1 Protein Is a Promising Biomarker to Predict Severe Liver Inflammation in Chronic
Mingrong Ou1, Weiming Zhang2, Wen Zhang3
1Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008, China.
Insights
High serum soluble programmed cell death 1 protein (sPD-1) levels indicate severe liver inflammation in chronic hepatitis B (CHB) patients. sPD-1 serves as an independent predictor for severe liver inflammation, improving diagnostic accuracy.
Area of Science:
- Hepatology
- Immunology
- Virology
Background:
- Liver inflammation is crucial for guiding antiviral treatment and monitoring chronic hepatitis B (CHB) progression.
- Soluble programmed cell death 1 protein (sPD-1) is elevated in inflammatory and infectious conditions, correlating with disease severity.
Purpose of the Study:
- To investigate the association between serum sPD-1 levels and liver inflammation in CHB patients.
- To evaluate the utility of sPD-1 in indicating liver inflammation severity.
Main Methods:
- 241 CHB patients undergoing liver biopsy were analyzed.
- Correlation between sPD-1 levels and liver inflammation degree was assessed.
- Logistic regression and ROC curve analysis were used to build and validate a predictive model for severe liver inflammation.
Main Results:
- Serum sPD-1 levels were significantly higher in CHB patients with severe liver inflammation compared to those with mild or moderate inflammation (P < 0.001).
- sPD-1 showed a weak correlation with AST (r = 0.278, P < 0.001).
- Multivariable analysis identified sPD-1 as an independent predictor of severe liver inflammation, with the predictive model achieving high diagnostic accuracy (AUROC 0.917-0.921).
Conclusions:
- Serum sPD-1 levels are significantly associated with liver inflammation in CHB patients.
- Elevated sPD-1 levels are indicative of severe liver inflammation and serve as an independent predictive marker.
- Incorporating sPD-1 into clinical assessments enhances the diagnostic accuracy for severe liver inflammation in CHB.
Abstract:
Background and Aims: Liver inflammation is important in guiding the initiation of antiviral treatment and affects the progression of chronic hepatitis B(CHB). The soluble programmed cell death 1 protein (sPD-1) was upregulated in inflammatory and infectious diseases and correlated with disease severity. We aimed to investigate the correlation between serum sPD-1 levels and liver inflammation in CHB patients and their role in indicating liver inflammation. Methods: 241 CHB patients who underwent liver biopsy were enrolled. The correlation between sPD-1 levels and the degree of liver inflammation was analyzed. Univariate and multivariate logistic regression analyses were performed to analyze independent variables of severe liver inflammation. Binary logistic regression analysis was conducted to construct a predictive model for severe liver inflammation, and the receiver operating characteristic curve (ROC) was used to evaluate the diagnostic accuracy of the predictive model. Results: sPD-1 was highest in CHB patients with severe liver inflammation, which was higher than that in CHB patients with mild or moderate liver inflammation (P < 0.001). Besides, sPD-1 was weakly correlated with AST (r = 0.278, P < 0.001). Multivariable analysis showed that sPD-1 was an independent predictor of severe liver inflammation. The predictive model containing sPD-1 had areas under the ROC (AUROCs) of 0.917 and 0.921 in predicting severe liver inflammation in CHB patients and CHB patients with ALT ≤ 1× upper limit of normal (ULN), respectively. Conclusions: Serum sPD-1 level is associated with liver inflammation in CHB patients, and high levels of sPD-1 reflect severe liver inflammation. Serum sPD-1 is an independent predictor of severe liver inflammation and shows improved diagnostic accuracy when combined with other clinical indicators.
