免疫学测量天冬氨酸/丙氨酸氨基转移酶预测肝纤维化和炎症

StephenW

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

StephenW

韩国J实习医生。 2019年1月23日doi：10.3904 / kjim.2018.214。 [印刷前的电子版]
免疫学测量天冬氨酸/丙氨酸氨基转移酶预测肝纤维化和炎症。
Kim HJ1，Kim SY2，Shin SP2，Yang YJ2，Bang CS2，Baik GH2，Kim DJ2，Ham YL3，Choi EY1，Suk KT2。
作者信息

1
    韩国春川Boditech中央研究所。
2
    韩国春川市Hallym大学医学院内科。
3
    韩国Jecheon，Daewon大学学院紧急医疗技术系。

抽象
背景/目的：

天冬氨酸/丙氨酸氨基转移酶（AST / ALT）的酶促分析并不完全代表肝纤维化或炎症的进展。 AST（细胞质[c] AST /线粒体[m] AST）和ALT（ALT1 / ALT2）的免疫测定已被建议作为酶分析的一种替代方法。本研究的目的是评估免疫测定在预测肝纤维化和炎症方面的功效。
方法：

招募了219名患有慢性乙型肝炎（CHB）的患者，他们在抗病毒治疗前接受了肝静脉压力梯度（HVPG）和肝活检。在HVPG期间从血液制备血清样品。通过含有荧光标记的单克隆抗体的夹心酶联免疫吸附试验（ELISA）免疫分析，将生物化学参数（包括酶促AST / ALT）和cAST，mAST，ALT1和ALT2的免疫学检测结果与METAVIR活纤维化阶段的结果进行了比较。 Knodell级炎症。
结果：

METAVIR纤维化阶段如下：F0,6（3％）; F1,52（24％）; F2,88（40％）; F3,45（20％）;和F4,28名患者（13％）。 AST和ALT的平均水平分别为121±157和210±279IU / L.所有患者的平均HVPG评分为4.7±2.5 mmHg。根据肝纤维化的阶段，来自CHB患者的所有样品中HVPG评分（p <0.001，r = 0.439）和ALT1水平（p <0.001，r = 0.283）显着增加。 ALT（p <0.001，r = 0.310），ALT1（p <0.001，r = 0.369）和AST（p <0.001，r = 0.374）水平与Knodell炎症等级正相关。
结论：

利用夹心ELISA免疫分析法测定ALT1可作为预测CHB患者炎症分级和纤维化分期的有用方法。
关键词：

丙氨酸氨基转移酶;天冬氨酸转移酶;酶联免疫吸附测定;乙型肝炎，慢性

结论：
    30665287
DOI：
    10.3904 / kjim.2018.214