Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 14, 2013; 19(18): 2818-2825
Published online May 14, 2013. doi: 10.3748/wjg.v19.i18.2818
Increased CD163 expression is associated with acute-on-chronic hepatitis B liver failure
Hong Ye, Li-Yuan Wang, Jing Zhao, Kai Wang
Hong Ye, Li-Yuan Wang, Jing Zhao, Kai Wang, Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Kai Wang, Institute of Hepatology, Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Ye H and Wang K designed research; Ye H, Wang LY and Zhao J performed research and provided analytic tools; Ye H and Wang LY analyzed data; Ye H and Wang K wrote the paper.
Supported by Grants from Key Project of Chinese Ministry of Science and Technology, No. 2012ZX10002007 and No. 2013ZX10002001; National Natural Science Foundation of China, No. 81171579 and No. 81201287; and Natural Science Foundation of Shandong Province, No. ZR2010HM070 and No. ZR2010HQ040
Correspondence to: Dr. Kai Wang, Department of Hepatology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan 250012, Shandong Province, China. wangdoc876@126.com
Telephone: +86-531-82169596 Fax: +86-531-86927544
Received: November 13, 2012
Revised: March 14, 2013
Accepted: March 23, 2013
Published online: May 14, 2013
Abstract

AIM: To assess CD163 expression in plasma and peripheral blood and analyze its association with disease in acute-on-chronic hepatitis B liver failure (ACHBLF) patients.

METHODS: A retrospective study was conducted from January 1, 2011 to January 1, 2012. Forty patients with ACHBLF (mean age 44.48 ± 12.28 years, range 18-69 years), 40 patients with chronic hepatitis B (CHB) (mean age 39.45 ± 12.22 years, range 21-57 years) and 20 age- and sex-matched healthy controls (mean age 38.35 ± 11.97 years, range 28-60 years) were included in this study. Flow cytometry was used to analyze the frequency of CD163+ peripheral blood mononuclear cells (PBMCs) and surface protein expression of CD163. Real-time transcription-polymerase chain reaction was performed to assess relative CD163 mRNA levels in PBMCs. Plasma soluble CD163 (sCD163) levels were measured by enzyme-linked immunosorbent assay. Clinical variables were also recorded. Comparisons between groups were analyzed by Kruskal-Wallis H test and Mann-Whitney U test. Statistical analyses were performed using SPSS 15.0 software and a P value < 0.05 was considered statistically significant.

RESULTS: Flow cytometry showed that the population of CD163+ PBMCs was significantly greater in ACHBLF patients than in CHB patients and healthy controls (47.9645% ± 17.1542%, 32.0975% ± 11.0215% vs 17.9460% ± 6.3618%, P < 0.0001). However, there were no significant differences in mean fluorescence intensity of CD163+ PBMCs within the three groups (27.4975 ± 11.3731, 25.8140 ± 10.0649 vs 20.5050 ± 6.2437, P = 0.0514). CD163 mRNA expression in ACHBLF patients was significantly increased compared with CHB patients and healthy controls (1.41 × 10-2± 2.18 × 10-2, 5.10 × 10-3± 3.61 × 10-3vs 37.0 × 10-4± 3.55 × 10-4, P = 0.02). Plasma sCD163 levels in patients with ACHBLF were significantly increased compared with CHB patients and healthy controls (4706.2175 ± 1681.1096 ng/mL, 1089.7160 ± 736.8395 ng/mL vs 435.9562 ± 440.8329 ng/mL, P < 0.0001). In ACHBLF patients, plasma sCD163 levels were significantly positively associated with model for end-stage liver disease scores (r = 0.5075, P = 0.008), hepatitis B virus-DNA (r = 0.6827, P < 0.0001), and negatively associated with prothrombin activity (r = -0.3348, P = 0.0347), but had no correlation with total bilirubin (r = 0.2551, P = 0.1122). Furthermore, sCD163 was obviously elevated in non-surviving patients compared with surviving patients with ACHBLF (5344.9080 ± 1589.5199 ng/mL vs 3641.7333 ± 1264.5228 ng/mL, P = 0.0321).

CONCLUSION: CD163 and sCD163 may be related to disease severity and prognosis in ACHBLF patients.

Keywords: Acute-on-chronic hepatitis B liver failure, Model for end-stage liver disease, CD163, Soluble CD163, Real-time transcription-polymerase chain reaction

Core tip: This study included three groups, acute-on-chronic hepatitis B liver failure (ACHBLF) patients, chronic hepatitis B (CHB) patients and healthy controls. Flow cytometry was used to analyze the frequency of CD163+ peripheral blood mononuclear cells (PBMCs) and surface protein expression of CD163. Real-time transcription-polymerase chain reaction was performed to assess relative CD163 mRNA levels in PBMCs. The population of CD163+ PBMCs was significantly larger in ACHBLF patients than in CHB patients and healthy controls. CD163 mRNA expression in ACHBLF patients was significantly increased compared with healthy controls. Plasma soluble CD163 (sCD163) levels were markedly increased and correlated with disease severity and prognosis in ACHBLF patients. CD163 and sCD163 may be useful biomarkers for ACHBLF.