Abstract
ObjectiveThe race for finding effective treatments for nonalcoholic fatty liver disease (NAFLD) has been slowed down by the high screen-failure rate for including patients in trials due to the lack of a noninvasive biomarker that can identify patients with significant disease. Recently, Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA+ -M2BP) has shown promise in predicting liver fibrosis. The aims of this study were to evaluate the utility of WFA+ -M2BP as a biomarker to sub-classify patients with NAFLD according to their disease severity and to assess its correlation with histologic features of NAFLD.MethodsPatients undergoing biopsy for clinical suspicion of NAFLD and healthy controls were included. Patients with NAFLD were classified into: NAFL, early NASH (F0-F1), fibrotic NASH (F2-F3), and NASH cirrhosis (F4). Levels of WFA+ -M2BP in sera was measured by a HISCL™ M2BPGi™ assay kit using an automated immunoanalyzer (HISCL™-800; Sysmex, Kobe, Japan). Analysis of covariance was used to assess difference in WFA+ -M2BP between the groups and Spearman’s correlation coefficients were used to assess correlation with histological features.ResultsOur cohort consisted of 20 healthy controls and 198 patients with biopsy-proven NAFLD divided as follows: 52 with NAFL, 62 with early NASH, 52 with fibrotic NASH, and 32 with NASH cirrhosis. WFA+ -M2BP level was found to be significantly increased in the fibrotic NASH and NASH cirrhosis groups compared to healthy controls and those with early NAFLD after adjusting for age, gender and BMI. Furthermore, patients with NASH cirrhosis had significantly higher WFA+ -M2BP levels (2.4[1.5, 4.2] C.O.I (Cut-off Index)) than those with fibrotic NASH (1.2[0.79, 1.9]), p < 0.001. WFA+ -M2BP level had moderate correlation with inflammation, ballooning and NAFLD activity score and strong correlation with fibrosis stage. Additionally, ROC curve analysis demonstrated that WFA+ -M2BP accurately differentiated F2-4 from F0-F1.ConclusionIn a large cohort of patients with the full spectrum of NAFLD, WFA+ -M2BP levels predicted the presence of advanced disease and correlated strongly with fibrosis stage.
Highlights
The initial description of nonalcoholic fatty liver disease (NAFLD) dates back to 1980 [1], its full spectrum and impact as a major chronic liver disease has only been recognized for the past 2 decades [2]
Our cohort consisted of 20 healthy controls and 198 patients with biopsy-proven NAFLD divided as follows: 52 with NAFL, 62 with early Nonalcoholic steatohepatitis (NASH), 52 with fibrotic NASH, and 32 with NASH cirrhosis
WFA+ -Mac-2 (galectin-3) binding protein (M2BP) level was found to be significantly increased in the fibrotic NASH and NASH cirrhosis groups compared to healthy controls and those with early
Summary
The initial description of nonalcoholic fatty liver disease (NAFLD) dates back to 1980 [1], its full spectrum and impact as a major chronic liver disease has only been recognized for the past 2 decades [2]. Liver biopsy remains the gold standard for differentiating between NAFL/ early NASH and fibrotic NASH in addition to providing information regarding the degree of steatosis, severity of inflammatory activity and stage of fibrosis. This need for biopsy/ histology to determine which patients require treatment and assess their response to therapy has slowed down the race for finding effective treatments for NAFLD due to patient hesitation to undergo several biopsies and the high screen-failure rate for including patients in clinical trial. There is an urgent need to develop a simple noninvasive biomarker that can classify patients into those with early disease and those with advanced disease that will benefit the most from pharmacologic treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
