Serum Leptin Serves as an Inflammatory Activity Marker and Predicts Steroid Response in Autoimmune Hepatitis

Abstract

Adipocytokines, especially leptin is involved in a wide spectrum of proinflammatory functions, in various tissues. This study was carried out to assess the role of serum leptin in autoimmune hepatitis. Serum leptin was analyzed in treatment naïve autoimmune hepatitis (AIH, n= 48) patients and compared with the primary biliary cholangitis (PBC, n= 16), chronic hepatitis C (CHC, n= 16) and healthy controls (n= 15). Serum leptin correlation was assessed on liver function tests, disease activity, T regulatory cells (Tregs), and Th17cells in the liver biopsies and on steroid treatment response in AIH. Serum leptin was higher in AIH than in PBC, CHC, and HC {AIH: 335 (106.2-580), PBC: 126 (52-381.2), CH: 67 (3.7-133.5) and HC: 66 (40-157.5) ng/ml; P= 0.001}. In AIH cases; serum leptin correlated with hepatic activity index (r= 0.896; P < 0.001); serum transaminases (aspartate aminotransferases (AST)= 0.615, P < 0.001, alanine aminotransferases (ALT)= 0.551, P < 0.001). It had inverse correlation with Treg cells (P=-0.711, P < 0.001) and positively correlated with Th17cells (r=0.650, P < 0.001) in the liver biopsy tissue. High serum leptin was found to be associated with steroid partial or nonresponsiveness at 4 weeks (P= 0.002). Serum leptin is indicative of higher AIH activity and a reduced number of Tregs cells in liver biopsy tissue. Leptin negative cases have more chances of steroid responsiveness and could help in the selection of AIH cases for appropriate therapy.