Serum prolyl-hydroxylase as an index of fibrogenic activity in chronic active hepatitis and cirrhosist

OBJECTIVETo evaluate serum prolyl-hydroxylase, an enzyme reflecting hepatic fibrogenic activity, in healthy subjects and patients with various liver diseases. DESIGNSerum prolyl-hydroxylase was evaluated in patients with varying degrees of liver damage and was related to standard liver function tests. METHODSOne hundred and thirty-one patients were studied, 25 with steatosis or chronic persistent hepatitis, 37 with chronic active hepatitis, 35 with Childʼs class A cirrhosis and 34 with Childʼs class B cirrhosis. Serum prolyl-hydroxylase was measured by means of an immune enzymatic method. RESULTSSerum prolyl-hydroxylase was found to be (mean ± SD) 62 ±15ng/ml in 43 healthy subjects, 70 ± 20 ng/ml in patients with steatosis or chronic persistent hepatitis, 174 ± 86 ng/ml in patients with chronic active hepatitis (P > 0.01 compared with healthy and other disease groups), 124 ± 62 ng/ml (P > 0.01 compared with healthy subjects) in patients with Childʼs class A cirrhosis and 94 ± 55 ng/ml in those with Childʼs class B cirrhosis. Serum prolyl-hydroxylase was related to liver function tests in multiple regression analysis (131 patients; r = 0.643, P > 0.001) confirming the hepatic source of this enzyme in chronic liver disease. CONCLUSIONThe higher values found in chronic active hepatitis and in the early stages of cirrhosis suggest that fibrogenesis, evaluated by means of serum prolyl-hydroxylase levels, is likely to be a reaction to inflammatory damage of the liver. On the basis of these results, serum prolyl-hydroxylase seems to be a possible marker for identifying fibrogenic activity in patients with chronic liver disease and could be a possible target for the evaluation of antifibrogenic drugs.