Abstract

BackgroundHepatitis B virus (HBV)-related liver disease induces liver damage by hepatic immune and inflammatory response. The association between aberrant peripheral blood mononuclear cell (PBMC) DNA methylation and progression of liver disease and fibrosis remains unclear.ResultsHere we applied Infinium 450 K BeadChip investigating PBMC genome-wide methylation profiling of 48 HBV-related liver disease patients including 24 chronic hepatitis B (CHB), 14 compensated liver cirrhosis (LC), and 10 decompensated liver cirrhosis (DLC). In total, there were 7888 differentially methylated CpG sites (36.06% hypermethylation, 63.94% hypomethylation) correlate with liver disease progression. LC was difficult to be diagnosed, intermediating between CHB and DLC. We used least absolute shrinkage and selection operator (LASSO)-logistic regression method to perform a LC predictive model. The predicted probability (P) of having LC was estimated by the combined model: P = 1/(1 − e−x), where X = 11.52 − 2.82 × (if AST within the normal range − 0.19 × (percent methylation of cg05650055) − 0.21 × (percent methylation of cg17149911 ). Pyrosequencing validation and confusion matrix analysis was used for internal testing, area under receiver operating characteristic curve (AUROC) of model was 0.917 (95% CI, 0.80–0.977). On the fibrosis progress, there were 1705 genes in LC compared with CHB, whose differentially methylated CpG sites loading within the “promoter” regions (including TSS1500, TSS200, 5′UTR, and the 1st exon of genes) subject into the enrichment analysis using Ingenuity Pathway Analysis (IPA). There were 113 enriched immune-related pathways indicated that HBV-related liver fibrosis progression caused epigenetic reprogramming of the immune and inflammatory response.ConclusionsThese data support idea that development of HBV-related chronic liver disease is linked with robust and broad alteration of methylation in peripheral immune system. CpG methylation sites serve as relevant biomarker candidates to monitor and diagnose LC, providing new insight into the immune mechanisms understanding the progression of HBV-related liver fibrosis and cirrhosis.

Highlights

  • Hepatitis B virus (HBV) infection is a common and growing global public health problem and Chronic hepatitis B (CHB)-related liver cirrhosis and hepatocellular carcinoma (HCC) are the cause of a high rate of morbidity and mortality [1]

  • WHO estimated that 257 million carriers of hepatitis B surface antigen (HBsAg) around the world in 2015, among which there were more than 887,000 deaths, mostly from hepatitis B resulted liver cirrhosis and HCC (World Health Organization fact sheets are available at www.who.int)

  • It is still dependent on liver biopsy that is traditional gold standard procedure for staging of fibrosis and diagnosis of liver cirrhosis (LC) in Chinese guidelines for the prevention and treatment of chronic hepatitis B [4] and AASLD 2018 Hepatitis B Guidance [5]

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Summary

Introduction

Hepatitis B virus (HBV) infection is a common and growing global public health problem and CHB-related liver cirrhosis and hepatocellular carcinoma (HCC) are the cause of a high rate of morbidity and mortality [1]. CT, MRI, and other imaging examinations are limited in the diagnosis of LC It is still dependent on liver biopsy that is traditional gold standard procedure for staging of fibrosis and diagnosis of LC in Chinese guidelines for the prevention and treatment of chronic hepatitis B (version 2019) [4] and AASLD 2018 Hepatitis B Guidance [5]. It is invasiveness with risk of serious complications [6], sampling limitation, and interpretational variability [7]; clinicians have been trying to seek more accurate and noninvasive tools for assessing LC. The association between aberrant peripheral blood mononuclear cell (PBMC) DNA methylation and progression of liver disease and fibrosis remains unclear

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