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Korean J Intern Med. 2019 Jan 23. doi: 10.3904/kjim.2018.214. [Epub ahead of print]
Immunological measurement of aspartate/alanine aminotransferase in predicting liver fibrosis and inflammation.
Kim HJ1, Kim SY2, Shin SP2, Yang YJ2, Bang CS2, Baik GH2, Kim DJ2, Ham YL3, Choi EY1, Suk KT2.
Author information
1
Boditech Central Research Institute, Chuncheon, Korea.
2
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
3
Department of Emergency Medical Technology, Daewon University College, Jecheon, Korea.
Abstract
Background/Aims:
Enzymatic analysis of aspartate/alanine aminotransferase (AST/ALT) does not exactly represent the progression of liver fibrosis or inflammation. Immunoassay for AST (cytoplasmic [c] AST/mitochondrial [m] AST) and ALT (ALT1/ALT2) has been suggested as one alternatives for enzymatic analysis. The objective of this study was to evaluate the efficacy of immunoassay in predicting liver fibrosis and inflammation.
Methods:
A total of 219 patients with chronic hepatitis B (CHB) who underwent hepatic venous pressure gradient (HVPG) and liver biopsy before antiviral therapy were recruited. Serum samples were prepared from blood during HVPG. Results of biochemical parameters including enzymatic AST/ALT and immunological assays of cAST, mAST, ALT1, and ALT2 through sandwich enzyme-linked immunosorbent assay (ELISA) immunoassay with fluorescence labeled monoclonal antibodies were compared with the results of METAVIR stage of live fibrosis and the Knodell grade of inflammation.
Results:
METAVIR fibrosis stages were as follows: F0, six (3%); F1, 52 (24%); F2, 88 (40%); F3, 45 (20%); and F4, 28 patients (13%). Mean levels of AST and ALT were 121 ± 157 and 210 ± 279 IU/L, respectively. Mean HVPG score of all patients was 4.7 ± 2.5 mmHg. According to the stage of liver fibrosis, HVPG score (p < 0.001, r = 0.439) and ALT1 level (p < 0.001, r = 0.283) were significantly increased in all samples from patients with CHB. ALT (p < 0.001, r = 0.310), ALT1 (p < 0.001, r = 0.369), and AST (p < 0.001, r = 0.374) levels were positively correlated with Knodell grade of inflammation.
Conclusions:
ALT1 measurement by utilizing sandwich ELISA immunoassay can be useful method for predicting inf lammation grade and fibrosis stage in patients with CHB.
KEYWORDS:
Alanine aminotransferase; Aspartate transferase; Enzyme-linked immunosorbent assay; Hepatitis B, chronic
PMID:
30665287
DOI:
10.3904/kjim.2018.214
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