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

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....

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Veröffentlicht in:World journal of gastroenterology : WJG 2024-03, Vol.30 (9), p.1177-1188
Hauptverfasser: Yu, Song-Man, Li, Hai, Deng, Guo-Hong, Wang, Xian-Bo, Zheng, Xin, Chen, Jin-Jun, Meng, Zhong-Ji, Zheng, Yu-Bao, Gao, Yan-Hang, Qian, Zhi-Ping, Liu, Feng, Lu, Xiao-Bo, Shi, Yu, Shang, Jia, Chen, Ruo-Chan, Huang, Yan
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Sprache:eng
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Zusammenfassung: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. To explore the prognostic value of sTREM-1 in patients with AD of cirrhosis. A multicenter prospective cohort of 442 patients with cirrhosis hospitalized for AD was divided into a study cohort ( = 309) and validation cohort ( = 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. 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. Serum sTREM-1 is a promising prognostic biomarker for ACLF development and mortality in patients with AD of cirrhosis.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v30.i9.1177