Increased serum activin a differentiates alcoholic from cirrhosis of other aetiologies

Introduction, background and aim Activin A is a molecule of the TGF superfamily, implicated in liver fibrosis, regeneration and stem cell differentiation. However, data on activins in liver diseases are very few. The authors therefore studied serum levels of Activin A in chronic liver diseases. To identify the origin of Activin A, levels in the hepatic vein were estimated and expression of Activin A was studied in isolated rat Kupffer and stellate cells. Methods 162 patients participated in the study: 39 with Hepatocellular Carcinoma (HCC, 19 viral cirrhosis associated, 20 alcoholic cirrhosis associated), 18 with Chronic hepatitis C (CHC), 47 with Primary Biliary Cirrhosis (PBC, 26 stage I–II and 21 stage IV), 22 with Alcoholic cirrhosis (hepatic vein blood available in 16), 20 with HCV cirrhosis (hepatic vein blood available in 18) and 16 patients with alcoholic fatty liver with mild to moderate fibrosis but no cirrhosis. 19 normal controls were also included. A commercially available ELISA was used for serum determinations and a semiquantitative PCR for Activin A expression in isolated rat Kupffer and Stellate cells. Results Activin-A levels were significantly increased (p