Correlation between serum galectin-9 levels and liver fibrosis

Background and Aim Chronic liver diseases (CLDs) progress from chronic inflammation to fibrosis to tumorigenesis. Galectin-9, a β-galactoside-specific animal lectin, is indicated to contribute to all three steps of progression. The aim of this study was to determine which of the three steps was most dominant in elevating the serum galectin-9 concentration and to test the possibility of galectin-9 as a serum biomarker. Methods Japanese patients with chronic hepatitis (CH), liver cirrhosis (LC), hepatocellular carcinoma (HCC), nonalcoholic fatty liver disease or alcoholic liver disease who provided informed consent were enrolled in this study. Serum galectin-9 levels were measured using a sandwich ELISA. Multiple regression analyses were performed using EZR to identify factors which determined serum galectin-9 concentration. Results One hundred one patients with 50 of CH and 51 of LC were enrolled; the cohort included 45 cases of HCV infection, 13 cases of HBV infection, 46 cases with HCC-related complications. The median serum galectin-9 concentration was 77.54pg/ml (inter quartile range: 18.89-241.9pg/ml). Multiple linear regression analyses proved Fib-4 index and APRI, indexes of liver fibrosis, were able to predict the serum galectin-9 levels with statistical significance. A multiple logistic regression analysis determined 10pg/ml increase of the serum galectin-9 concentration presented an odds ratio of 3.90 for liver fibrosis progression. Conclusions The serum galectin-9 concentration represents a potential biomarker of liver fibrosis in patients with CLDs, regardless of chronic inflammation or the presence of HCC complications. Furthermore, higher serum galectin-9 levels are a predictor for liver fibrosis progression.