Title: Serum hyaluronate reflects hepatic fibrogenesis in alcoholic liver disease and is useful as a marker of fibrosis
Abstract: HepatologyVolume 24, Issue 6 p. 1399-1403 Original ArticleFree Access Serum hyaluronate reflects hepatic fibrogenesis in alcoholic liver disease and is useful as a marker of fibrosis A Pares M.D., A Pares M.D. Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorR Deulofeu, R Deulofeu Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorA Gimenez, A Gimenez Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorL Caballeria, L Caballeria Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorM Bruguera, M Bruguera Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorJ Caballeria, J Caballeria Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorA M Ballesta, A M Ballesta Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorJ Rodes, J Rodes Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this author A Pares M.D., A Pares M.D. Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorR Deulofeu, R Deulofeu Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorA Gimenez, A Gimenez Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorL Caballeria, L Caballeria Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorM Bruguera, M Bruguera Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorJ Caballeria, J Caballeria Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorA M Ballesta, A M Ballesta Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this authorJ Rodes, J Rodes Alcohol and Liver Units, and Laboratory of Biochemistry, Hospital Clinic i Provincial, University of Barcelona, SpainSearch for more papers by this author First published: December 1996 https://doi.org/10.1002/hep.510240615Citations: 106AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract The high levels of hyaluronic acid (HA), a glycosaminoglycan of the liver extracellular matrix, which is synthesized and degraded in the liver sinusoidal cells, have been related with a decreased function of the endothelial sinusoidal cells. The relevance of HA in alcoholic liver disease has not been sufficiently evaluated, and therefore the current study was addressed to assess whether serum HA reflects the severity of liver fibrosis and fibrogenesis as well as the potential usefulness of hyaluronic acid as a marker of early fibrosis in alcoholics with liver damage. Serum HA and aminoterminal propeptide of collagen III (PIIIP) levels, a marker of liver fibrogenesis in alcoholics with liver disease, were assessed in 45 chronic alcoholic patients (31 men and 14 women, age: 44.1 ± 1.5 years) (normal liver = 7; fatty changes = 8; fibrosis = 7; alcoholic hepatitis = 6; cirrhosis = 6; and cirrhosis plus alcoholic hepatitis = 11). The severity of liver inflammation and fibrosis were scored in liver specimens as: 0, no lesion; 1+ mild; 2+ moderate; and 3+ severe. Twenty-seven patients (60%) had HA above normal values (1 patient with fatty changes, 3 patients with fibrosis, and all patients with alcoholic hepatitis or cirrhosis). Hyaluronic acid and (PIIIP) levels increased in parallel with the severity of liver damage. Hyaluronic acid levels were higher in those patients with more liver inflammation (0, 128 ± 38; 1+, 553 ± 141; 2+, 668 ± 259; 3+, and 1,073 ± 419 microg/L; P = .004) and of fibrosis (0, 79 ± 32; 1+, 156 ± 70; 2+, 219 ± 105; and 3+, 695 ± 114 microg/L; P < .001). Procollagen III peptide levels were related with fibrosis (0, 17 ± 1; 1+, 25 ± 6; 2+, 47 ± 13; 3+, and 55 ± 9 ng/mL; P = .002) but not with inflammation (0, 29 ± 7; 1+, 45 ± 7; 2+, 54 ± 9; 3+, and 66 ± 30 ng/mL, P: not significant). Moreover, a direct linear correlation was observed between HA and PIIIP (r = .72, P < .001). A receiver operating characteristic (ROC) curve analysis revealed that HA was similar to PIIIP levels in discriminating between alcoholics without fibrosis and those with fibrosis (area under the ROC curves) (.913 ± .042 vs. .867 ± .054; P: n.s). In conclusion, serum HA reflects the severity of liver inflammation, fibrosis, and fibrogenesis in patients with alcoholic liver disease and is useful as a marker of precirrhotic and cirrhotic stages. References 1 MacSween RNM, Burt AD. Histologic spectrum of alcoholic liver disease. Semin Liver Dis 1986; 6: 221– 232. 2 Van Waes L, Lieber CS. Early perivenular sclerosis in alcoholic fatty liver: an index of progressive liver injury. Gastroenterology 1977; 73: 646– 650. 3 Nakano M, Worner TM, Lieber CS. Perivenular fibrosis in alcoholic liver injury:ultrastructure and histologic progression. Gastroenterology 1982; 83: 777– 785. 4 Worner TM, Lieber CS. Perivenular fibrosis as precursor lesion of cirrhosis. 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