Circulating histone H4 values can relate to disease severity in patients with alcoholic hepatitis and cirrhosis

We aimed to evaluate whether serum histone H4 (sHH4) is associated with alcoholic liver disease (ALD) phenotypes.

This case-control study included 66 ALD patients and 47 healthy controls (HCs). Patients with ALD were classified into three groups: alcohol-associated steatotic liver, alcoholic hepatitis (AH), and alcoholic cirrhosis (AC). The HIST1H4A kit was used for the enzyme-linked immunosorbent assay of sHH4.

In the AH patients, the median sHH4 value was the highest and the lowest in the HC (3572.32 ng/L vs. 451 ng/L, respectively, p = 0.002). In the AC group, the median sHH4 value was higher in the Child-Pugh classification B (CPC-B) group than in the CPC-A group (p = 0.026). Positive correlations existed between the sHH4 value and the duration of alcohol use and Maddrey's discriminant function scores in patients with AH (rho = 0.886, p = 0.019 for both). In the AC patients, a positive correlation was noted between the sHH4 values and The Model for End-stage Liver Disease Sodium scores (rho = 0.527, p = 0.006).

Increased sHH4 values might be a marker for the severity of AH and AC.