Published online Sep 27, 2023. doi: 10.4254/wjh.v15.i9.1043
Peer-review started: June 8, 2023
First decision: August 5, 2023
Revised: August 21, 2023
Accepted: September 14, 2023
Article in press: September 14, 2023
Published online: September 27, 2023
After receiving entecavir or combined with FuzhengHuayu tablet (FZHY) treatment, some sufferers with hepatitis B virus (HBV)-related liver fibrosis could achieve a histological improvement while the others may fail to improve even worsen. Serum metabolomics at baseline in these patients who were effective in treatment remain unclear.
The key significance of this cross-sectional study is to predict the serum metabolites of the treatment (entecavir or entecavir + FZHY) that effectively reversed HBV-related liver fibrosis.
We are about to explore serum differential metabolites and metabolic pathways at baseline in HBV-related liver fibrosis patients who are response to the treatments.
A total of 132 patients with HBV-related liver fibrosis and 18 volunteers as healthy controls were recruited. First, all subjects were divided into training set and validation set. Second, the included patients were subdivided into entecavir responders (E-R), entecavir no-responders (E-N), FZHY + entecavir responders (F-R), and FZHY + entecavir no-responders (F-N) following the pathological histological changes after 48 wk’ treatments. Then, serum samples of all subjects before treatment were tested by high-performance liquid chromatography-tandem mass spectrometry. Data processing was conducted using multivariate principal component analysis and orthogonal partial least squares discriminant analysis. Diagnostic tests of selected differential metabolites were used for Boruta analyses and logistic regression.
As for the intersection about differential metabolic pathways between the groups E-R vs E-N and F-R vs F-N, results showed that 4 pathways including Linoleic acid metabolism, aminoacyl-tRNA biosynthesis, cyanoamino acid metabolism, alanine, aspartate and glutamate metabolism were screened out. As for the differential metabolites, these 7 intersected metabolites including hydroxypropionic acid, tyrosine, citric acid, taurochenodeoxycholic acid, benzoic acid, 2-furoic acid, and propionic acid were selected.
Our findings showed that 4 metabolic pathways and 7 differential metabolites have potential usefulness in clinical prediction of the response of entecavir or combined with FZHY on HBV fibrotic liver.
It is of great theoretical and practical significance to prevent the transformation of liver fibrosis to cirrhosis or even hepatocellular carcinoma and reduce the social burden.