The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Immunological measurement of aspartate/alanine aminotransferase in predicting liver fibrosis and inflammation

  • Kim, Hyun Jeong (Boditech Central Research Institute) ;
  • Kim, Sang Yeol (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Shin, Suk Pyo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Yang, Young Joo (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Bang, Chang Seok (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Baik, Gwang Ho (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Dong Joon (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Ham, Young Lim (Department of Emergency Medical Technology, Daewon University College) ;
  • Choi, Eui Yul (Boditech Central Research Institute) ;
  • Suk, Ki Tae (Department of Internal Medicine, Hallym University College of Medicine)
  • Received : 2018.06.19
  • Accepted : 2018.10.01
  • Published : 2020.03.01
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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

Acknowledgement

This study was funded by Hallym University Specialization Fund (HRF-S-53). This research was supported through a grant from Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2018M3A9F3020956 and NRF2018M3A9F3020942). This research was supported by Hallym University Research Fund and Hallym University Research Fund 2016 (HURF-2016-60).

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