新型生物标志物治疗慢性乙型肝炎

StephenW

Novel Biomarkers for the Management of Chronic Hepatitis B
Takako Inoue  1 , Yasuhito Tanaka  1   2   3
Affiliations

    PMID: 32536045 DOI: 10.3350/cmh.2020.0032

Abstract

Hepatitis B virus (HBV) cannot be eliminated completely from infected hepatocytes because of the presence of intrahepatic covalently closed circular DNA (cccDNA). As chronic hepatitis B (CHB) can progress to cirrhosis and hepatocellular carcinoma (HCC), it is important to manage CHB to prevent HCC development in high-risk patients with high viral replicative activity or advanced fibrosis. Serum biomarkers are noninvasive and valuable for the management of CHB. Hepatitis B core-related antigen (HBcrAg) correlates with serum HBV DNA and intrahepatic cccDNA. In CHB patients with undetectable serum HBV DNA or loss of HBsAg, HBcrAg still can be detected and the decrease in HBcrAg levels is significantly associated with hopeful outcomes. Therefore, HBcrAg can predict HCC occurrence or recurrence. Measurement of the Mac-2 binding protein glycosylation isomer (M2BPGi) has been introduced for the evaluation of liver fibrosis. Because elevated M2BPGi in CHB is related to liver fibrosis and the prediction of HCC development, monitoring its progression is essential. Because alpha fetoprotein (AFP) has insufficient sensitivity and specificity for early-stage HCC, a combination of AFP plus protein induced by vitamin K absence factor II, or AFP plus Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein might improve the diagnosis of HCC development. Additionally, Dickkopf-1 and circulating immunoglobulin G antibodies are the novel markers to diagnose HCC or assess HCC prognosis. This review provides an overview of novel HBV biomarkers used for the management of intrahepatic viral replicative activity, liver fibrosis, and HCC development.

Keywords: Alpha-fetoprotein; Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein; Mac 2-binding protein glycan isomer; Protein induced by vitamin K absence or antagonist-II; Hepatitis B core-related antigen.

StephenW

新型生物标志物治疗慢性乙型肝炎
井上贵子1，田中靖人1 2 3
隶属关系

    PMID：32536045 DOI：10.3350 / cmh.2020.0032

抽象

由于存在肝内共价封闭的环状DNA（cccDNA），无法从感染的肝细胞中完全清除乙型肝炎病毒（HBV）。由于慢性乙型肝炎（CHB）可能会发展为肝硬化和肝细胞癌（HCC），因此，重要的是要控制CHB以防止具有高病毒复制活性或晚期纤维化的高危患者发生HCC。血清生物标志物是无创性的，对于CHB的管理很有价值。乙型肝炎核心相关抗原（HBcrAg）与血清HBV DNA和肝内cccDNA相关。在无法检测到血清HBV DNA或HBsAg缺失的CHB患者中，仍然可以检测到HBcrAg，并且HBcrAg水平的降低与希望的结果显着相关。因此，HBcrAg可以预测HCC的发生或复发。已经引入了Mac-2结合蛋白糖基化异构体（M2BPGi）的测量，以评估肝纤维化。由于CHB中M2BPGi升高与肝纤维化和HCC发生的预测有关，因此监测其进展至关重要。由于甲胎蛋白（AFP）对早期HCC的敏感性和特异性不足，因此联合使用AFP加维生素K缺乏因子II诱导的蛋白，或AFP加lens culinaris凝集素反应性甲胎蛋白可提高HCC的诊断率发展。此外，Dickkopf-1和循环免疫球蛋白G抗体是诊断HCC或评估HCC预后的新型标志物。这篇综述概述了用于管理肝内病毒复制活性，肝纤维化和HCC发育的新型HBV生物标志物。

关键词：甲胎蛋白；晶状体凝集素反应性甲胎蛋白的分数； Mac 2结合蛋白聚糖异构体；缺乏维生素K或拮抗剂II诱导的蛋白质;乙型肝炎核心相关抗原。

StephenW

https://www.e-cmh.org/upload/pdf/cmh-2020-0032.pdf

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