Diagnosis value and correlation of macrophage stimulating protein with immune regulatory factors in acute-on-chronic liver failure patients

Abstract

Objective To observe the expression level of macrophage stimulating protein (MSP) in acute-on-chronic liver failure (ACLF) patients, and to explore the clinical significance and correlation with different immune regulatory factors. Methods The double antigen sandwich enzyme-linked immunosorbent assay method was used to detect MSP in the peripheral blood of 45 patients who were diagnosed with ACLF and 32 cases of chronic hepatitis B (CHB). The MSP levels were compared among ACLF patients with different outcomes, and the MSP level of healthy person was used as control. Meanwhile, liver function and hepatitis B virus (HBV) load were detected, and the expressions of peripheral blood CD4+ interferon (IFN)γ+ (helper T cell 1 Th1), CD4+ interleukin (IL)-4+ (helper T cell 2, Th2), CD4+ IL-17+ (helper T cell 17, Th17) and CD4+ CD25+ Foxp3+ (regular T cell, Treg) were measured by flow cytometry. The comparison of means between two samples was done by t test, and one-way ANOVA and linear correlation analysis were also used. Results The serum MSP levels in ACLF patients , CHB group and healthy control were (1.65±0.46) ng/mL, (1.43±0.32) ng/mL and (1.23±0.21) ng/mL, respectively. The serum MSP level in ACLF patients was significantly higher than both CHB patients (t=2.163, P=0.035) and healthy control (t=4.032, P=0.01). The MSP level in ACLF survival group was statistically higher compared with ACLF death group ( ng/mL vs ng/mL, t=1.973, P=0.042). Th2, Th17 cells in ACLF group, CHB group and healthy control group were (1.51±0.27)% and (1.94±1.02)%, (0.42±0.08)% and (0.55±0.36)%, (0.23±0.19) % and (0.26±0.19)%, respectively, which were all significantly different (F=7.759 and 37.229, respectively; both P 0.05). Conclusion MSP is involved in the progress of ACLF, and it may be associated with clinical outcomes and cellular immune imbalance of ACLF patients. Key words: Acute-on-chronic liver failure; Macrophage stimulating protein; Immunity, cellular