Wisteria floribunda agglutinin positive Mac-2-binding protein level increases in patients with acute liver injury.

Abstract

Wisteria floribunda agglutinin positive human Mac-2-binding protein glycosylation isomer (M2BPGi) is a novel serum glycomarker for liver fibrosis. However, it is not known whether or not M2BPGi reflects only liver fibrosis. We measured serum M2BPGi levels in patients with acute liver injury. Fifty-one patients with acute liver injury were enrolled. M2BPGi levels were measured at the initial visit and at achievement of recovery. The relationship between M2BPGi values at the initial visit and clinical outcomes was analyzed. Serum M2BPGi levels at the initial visit were elevated in 47 of 51 acute liver injury patients (8.33±7.56 cutoff index). M2BPGi values were associated with prothrombin activity (r=-0.600, P=0.001), total bilirubin level (r=0.588, P=0.001), and Model for End-Stage Liver Disease score (r=0.490, P=0.001) but not with aspartate aminotransferase (r=-0.070) and alanine aminotransferase (r=-0.073) levels. M2BPGi values at the initial visit were significantly higher in patients with acute liver failure (diagnosed by prothrombin activity of 40% or less; P<0.001), subsequent development of hepatic coma (P=0.036), and subsequent requirement of liver transplant (P=0.014), and in a patient who died (P=0.045). M2BPGi values decreased after aminotransferase level normalization in patients who recovered from acute liver injury; however, M2BPGi level was not a predictive factor for recovery with medical therapy. Serum M2BPGi values increased in patients with acute liver injury and decreased following recovery. The marker seems to reflect not only liver fibrosis but also other factors, such as liver inflammation, liver damage, and hepatocyte regeneration.