sTREM-1 as promising prognostic biomarker for acute-on-chronic liver failure and mortality in patients with acute decompensation of cirrhosis  

作　　者：Song-Man Yu Hai Li Guo-Hong Deng Xian-Bo Wang Xin Zheng Jin-Jun Chen Zhong-Ji Meng Yu-Bao Zheng Yan-Hang Gao Zhi-Ping Qian Feng Liu Xiao-Bo Lu Yu Shi Jia Shang Ruo-Chan Chen Yan Huang 

机构地区：[1]Department of Infectious Diseases,Xiangya Hospital,Central South University,Changsha 410000,Hunan Province,China [2]Department of Gastroenterology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China [3]Department of Infectious Diseases,Southwest Hospital,Third Military Medical University(Army Medical University),Chongqing 400038,China [4]Center of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100020,China [5]Department of Infectious Diseases,Institute of Infection and Immunology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430020,Hubei Province,China [6]Department of Infectious Diseases,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China [7]Department of Infectious Disease,Taihe Hospital,Hubei University of Medicine,Shiyan 442009,Hubei Province,China [8]Department of Infectious Diseases,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,Guangdong Province,China [9]Department of Hepatology,The First Hospital of Jilin University,Changchun 130021,Jilin Province,China [10]Department of Liver Intensive Care Unit,Shanghai Public Health Clinical Centre,Fudan University,Shanghai 200093,China [11]Tianjin Institute of Hepatology,Nankai University Second People's Hospital,Tianjin 300192,China [12]Infectious Disease Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang Uygur Autonomous Region,China [13]The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital of School of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Provine,China [14]Department of Infectious Diseases,Henan Provincial People's Hospital,Zhengzhou 463599,Henan Provine,China [15]Department of Infectious Diseases,Hunan Key Laboratory of Viral Hepatitis,Xiangya Hospital,Central South University,Changsha 110051,Hunan Provine,China

出　　处：《World Journal of Gastroenterology》2024年第9期1177-1188,共12页世界胃肠病学杂志（英文版）

基　　金：National Natural Science Foundation of China,No.81970550,No.82070613 and No.82370638;Natural Science Foundation of Hunan Province,China,No.2021JJ31067 and No.2021JJ41048;Hunan innovative province construction project,No.2023JJ10095;Innovative Talented Project of Hunan province,China,No.2022RC1212.

摘　　要：BACKGROUND Acute decompensation(AD)of cirrhosis is associated with high short-term mortality,mainly due to the development of acute-on-chronic liver failure(ACLF).Thus,there is a need for biomarkers for early and accurate identification of AD patients with high risk of development of ACLF and mortality.Soluble triggering receptor expressed on myeloid cells-1(sTREM-1)is released from activated innate immune cells and correlated with various inflammatory processes.AIM To explore the prognostic value of sTREM-1 in patients with AD of cirrhosis.METHODS A multicenter prospective cohort of 442 patients with cirrhosis hospitalized for AD was divided into a study cohort(n=309)and validation cohort(n=133).Demographic and clinical data were collected,and serum sTREM-1 was measured at admission.All enrolled patients were followed-up for at least 1 year.RESULTS In patients with AD and cirrhosis,serum sTREM-1 was an independent prognosis predictor for 1-year survival and correlated with liver,coagulation,cerebral and kidney failure.A new prognostic model of AD(P-AD)incorporating sTREM-1,blood urea nitrogen(BUN),total bilirubin(TBil),international normalized ratio(INR)and hepatic encephalopathy grades was established and performed better than the model for end-stage liver disease(MELD),MELD-sodium(MELD-Na),chronic liver failure-consortium(CLIF-C)ACLF and CLIF-C AD scores.Additionally,sTREM-1 was increased in ACLF and predicted the development of ACLF during first 28-d follow-up.The ACLF risk score incorporating serum sTREM-1,BUN,INR,TBil and aspartate aminotransferase levels was established and significantly superior to MELD,MELD-Na,CLIF-C ACLF,CLIF-C AD and P-AD in predicting risk of ACLF development.CONCLUSION Serum sTREM-1 is a promising prognostic biomarker for ACLF development and mortality in patients with AD of cirrhosis.

关 键 词：Soluble triggering receptor expressed on myeloid cell-1 Acute decompensation CIRRHOSIS Acute-on-chronic liver failure Prognostic biomarker 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]