Serum Anti-Fumarate Hydratase Autoantibody as a Biomarker for Predicting Prognosis of Acute-on-Chronic Liver Failure

Linlin Wei; Ting Wang; Sisi Chen; Yeying Liu; Xueying Huang; Sujun Zheng; Bin Xu; Feng Ren; Mei Liu

doi:10.5009/gnl220022

Gut and Liver (Sep 2023)

Serum Anti-Fumarate Hydratase Autoantibody as a Biomarker for Predicting Prognosis of Acute-on-Chronic Liver Failure

Linlin Wei,
Ting Wang,
Sisi Chen,
Yeying Liu,
Xueying Huang,
Sujun Zheng,
Bin Xu,
Feng Ren,
Mei Liu

Affiliations

Linlin Wei: The Second Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
Ting Wang: Departments of Respiration and Infection, Beijing Youan Hospital, Capital Medical University, Beijing, China
Sisi Chen: Departments of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
Yeying Liu: Departments of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
Xueying Huang: Departments of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China
Sujun Zheng: The First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
Bin Xu: The Second Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
Feng Ren: Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
Mei Liu: Departments of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, China

DOI: https://doi.org/10.5009/gnl220022
Journal volume & issue: Vol. 17, no. 5
pp. 795 – 805

Abstract

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Background/Aims: To investigate the autoantibody against fumarate hydratase (FH), which is a specific liver failure-associated antigen (LFAA) and determine whether it can be used as a biomarker to evaluate the prognosis of acute-on-chronic liver failure (ACLF). Methods: An immunoproteomic approach was applied to screen specific LFAAs related to differential prognosis of ACLF (n=60). Enzyme-linked immunosorbent assay (ELISA) technology was employed for the validation of the frequency and titer of autoantibodies against FH in ACLF patients with different prognoses (n=82). Moreover, we clarified the expression of autoantibodies against FH in patients with chronic hepatitis B (n=60) and hepatitis B virus-related liver cirrhosis (n=60). The dynamic changes in the titers of autoantibodies against FH were analyzed by sample collection at multiple time points during the clinical course of eight ACLF patients with different prognoses. Results: Ultimately, 15 LFAAs were screened and identified by the immunoproteomic approach. Based on ELISA-based verification, anti-FH/Fumarate hydratase protein autoantibody was chosen to verify its expression in ACLF patients. ACLF patients had a much higher anti-FH autoantibody frequency (76.8%) than patients with liver cirrhosis (10%, p=0.000), patients with chronic hepatitis B (6.7%, p=0.022), and normal humans (0%, p=0.000). More importantly, the frequency and titer of anti-FH protein autoantibodies in the serum of ACLF patients with a good prognosis were much higher than that of patients with a poor prognosis (83.9% vs 61.5%, p=0.019; 1.41±0.85 vs 0.94±0.56, p=0.017, respectively). The titer of anti-FH autoantibodies showed dynamic changes in the clinical course of ACLF. Conclusions: The anti-FH autoantibody in serum may be a potential biomarker for predicting the prognosis of ACLF.

Published in Gut and Liver

ISSN: 1976-2283 (Print); 2005-1212 (Online)
Publisher: Gastroenterology Council for Gut and Liver
Country of publisher: Korea, Republic of
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: https://www.gutnliver.org/main.html

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