Expression of M30 and CCL20 in serum in patients with HBV-related acute-on-chronic liver failure and their clinical significance

ObjectiveTo investigate the serum levels of M30 and CCL20 and their association with short-term (3-month) prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), as well as their clinical significance. MethodsA total of 51 patients with HBV-ACLF who were diagnosed and treated in Hunan Provincial People′s Hospital from October 2014 to January 2017 were enrolled as HBV-ACLF group; 30 patients with chronic hepatitis B (CHB) who were hospitalized or followed up in the outpatient service were enrolled as CHB group; 30 healthy individuals who underwent physical examination were enrolled as control group. The patients with HBV-ACLF were followed up for 3 months, and according to the results of follow-up, these patients were divided into survival group and death group. ELISA was used to measure the serum levels of M30 and CCL20 in peripheral blood before treatment and after two weeks of treatment. The t-test was used for comparison of continuous data between two groups, and an analysis of variance was used for comparison between multiple groups. ResultsThere were significant differences in the serum levels of M30 and CCL20 before treatment between the HBV-ACLF group, the CHB group, and the control group (M30: 591.54±262.06 U/L vs 241.58±120.33 U/L vs 114.35±52.09 U/L, F=22.75，P＜0.05; CCL20: 386.51±55.12 pg/ml vs 177.11±27.51 pg/ml vs 33.95±11.62 pg/ml, F=51.47,P＜005). After two weeks of treatment, the HBV-ACLF death group had a significantly higher level of M30 than the HBV-ACLF survival group (648.17±285.55 U/L vs 426.43±217.64 U/L, t=2.37, P＜0.05) and a significantly lower level of CCL20 than the HBV-ACLF survival group (232.28±3928 pg/ml vs 352.29±52.43 pg/ml, t=-2.35, P＜0.05). After 2 weeks of treatment, there were significant differences in the change rates of the serum levels of M30 and CCL20 between the two groups (M30: 0.08±0.04 vs 0.27±0.12, t=2.49, P＜0.05; CCL20: 0.39±0.06 vs 0.11±0.02, t=2.54, P＜0.05). ConclusionPatients with HBV-ACLF have significant increases in the serum levels of M30 and CCL20, which can accurately reflect cell apoptosis and inflammation in the liver. Patients with a significant reduction in CCL20 during treatment tend to have high mortality, and patients with a significant reduction in M30 tend to have good prognosis. Dynamic changes in M30 and CCL20 levels have a certain value in predicting the short-term prognosis of patients with HBV-ACLF.