Novel serum and bile protein markers predict primary sclerosing cholangitis disease severity and prognosis

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Vesterhus , M , Holm , A , Hov , J R , Nygard , S , Schrumpf , E , Melum , E , Thorbjornsen , L W , Paulsen , V , Lundin , K , Dale , I , Gilja , O H , Zweers , S J L B , Vatn , M , Schaap , F G , Jansen , P L M , Ueland , T , Rosjo , H , Moum , B , Ponsioen , C Y , Boberg , K M , Farkkila , M , Karlsen , T H & Lund-Johansen , F 2017 , ' Novel serum and bile protein markers predict primary sclerosing cholangitis disease severity and prognosis ' , Journal of Hepatology , vol. 66 , no. 6 , pp. 1214-1222 . https://doi.org/10.1016/j.jhep.2017.01.019

Title: Novel serum and bile protein markers predict primary sclerosing cholangitis disease severity and prognosis
Author: Vesterhus, Mette; Holm, Anders; Hov, Johannes Roksund; Nygard, Stale; Schrumpf, Erik; Melum, Espen; Thorbjornsen, Liv Wenche; Paulsen, Vemund; Lundin, Knut; Dale, Inge; Gilja, Odd Helge; Zweers, Serge J. L. B.; Vatn, Morten; Schaap, Frank G.; Jansen, Peter L. M.; Ueland, Thor; Rosjo, Helge; Moum, Bjorn; Ponsioen, Cyriel Y.; Boberg, Kirsten Muri; Farkkila, Martti; Karlsen, Tom H.; Lund-Johansen, Fridtjof
Contributor: University of Helsinki, Clinicum
Date: 2017-06
Language: eng
Number of pages: 9
Belongs to series: Journal of Hepatology
ISSN: 0168-8278
URI: http://hdl.handle.net/10138/235536
Abstract: Background & Aims: Prognostic biomarkers are lacking in primary sclerosing cholangitis, hampering patient care and the development of therapy. We aimed to identify novel protein biomarkers of disease severity and prognosis in primary sclerosing cholangitis (PSC). Methods: Using a bead-based array targeting 63 proteins, we profiled a derivation panel of Norwegian endoscopic retrograde cholangiography bile samples (55 PSC, 20 disease controls) and a Finnish validation panel (34 PSC, 10 disease controls). Selected identified proteins were measured in serum from two Norwegian PSC cohorts (n = 167 [1992-2006] and n = 138 [2008-2012]), inflammatory bowel disease (n = 96) and healthy controls (n = 100). Results: In the bile derivation panel, the levels of 14 proteins were different between PSC patients and controls (p <0.05); all were confirmed in the validation panel. Twenty-four proteins in the bile derivation panel were significantly (p <0.05) different between PSC patients with mild compared to severe cholangiographic changes (modified Amsterdam criteria); this was replicated for 18 proteins in the validation panel. Interleukin (IL)-8, matrix metallopeptidase (MMP)9/lipocalin (LCN)2-complex, S100A8/9, S100A12 and tryptophan hydroxylase (TPH)2 in the bile were associated with both a PSC diagnosis and grade of cholangiographic changes. Stratifying PSC patients according to tertiles of serum IL-8, but not MMP9/LCN2 and S100A12, provided excellent discrimination for transplant-free survival both in the serum derivation and validation cohort. Furthermore, IL-8 was associated with transplant-free survival in multivariable analyses in both serum panels independently of age and disease duration, indicating an independent influence on PSC progression. However, the Enhanced Liver Fibrosis (ELF (R)) test and Mayo risk score proved to be stronger predictors of transplant-free survival. Conclusions: Based on assaying of biliary proteins, we have identified novel biliary and serum biomarkers as indicators of severity and prognosis in PSC. Lay summary: Prognostic biomarkers are lacking in primary sclerosing cholangitis, hampering patient care and the development of therapy. We have identified inflammatory proteins including calprotectin and IL-8 as important indicators of disease severity and prognosis in bile and serum from patients with primary sclerosing cholangitis. (C) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Subject: PSC
Biomarker
Prognosis
Calprotectin
IL-8
NATURAL-HISTORY
POPULATION
MANAGEMENT
INTERLEUKIN-8
CALPROTECTIN
DIAGNOSIS
MODEL
3121 General medicine, internal medicine and other clinical medicine
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