Interleukin-1 receptor antagonist expression is inversely associated with outcomes of hepatitis B-related acute-on-chronic liver failure

Serum Interleukins as Potential Prognostic Biomarkers in HBV-Related Acute-on-Chronic Liver Failure

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is relatively common in China and has complex pathogenesis, difficult clinical treatment, and poor prognosis. Immune status is an important factor affecting ACLF prognosis. Interleukins are a family of secreted lymphocyte factors that interact with a host of cell types including immune cells. These signaling molecules play important roles in transmitting information; regulating immune cells; mediating the activation, proliferation, and differentiation of T and B cells; and modulating inflammatory responses. Many studies have investigated the correlation between interleukin expression and the prognosis of HBV-ACLF. This review focuses on the potential use of interleukins as prognostic biomarkers in HBV-ACLF. References were mainly identified through PubMed and CNKI search, including relevant studies published until December 2021. We have summarized reports of several promising diagnostic interleukin biomarkers that predict susceptibility to HBV-ACLF. The use of biomarkers to understand early prognosis can help devise different therapeutic measures and improve patient survival. Ongoing research on prognostic biomarkers of HBV-ACLF is promising, and future preclinical and clinical studies are warranted.

The association between SNPs and hepatitis B virus related acute-on-chronic liver failure

OBJECTIVE

This study intended to investigate the association between ten single nucleotide polymorphisms (rs1143623, rs12692386, rs1799983, rs2297518, rs2910164, rs3129859, rs4251961, rs4846085, rs641738, rs873457) with susceptibility and prognosis of hepatitis B related acute-on-chronic liver failure (HBV-ACLF).

METHODS

This is a hospital-based case-control study included 274 patients with HBV-ACLF and 534 patients with chronic hepatitis B. The patients who were successfully followed were divided into the survival group and the death group according to the clinical outcome during the hospitalization and 90 days after discharge. The ten SNPs were genotyped in all subjects by using imLDR. Genotype, allele frequency, dominant model, recessive model and codominant model were constructed to investigate the association between single nucleotide polymorphisms with susceptibility and prognosis of HBV-ACLF.

RESULTS

The genotype distribution of rs1143623 was statistically different between the two groups (P = 0.04), but the allele frequency was not statistically significant (P = 0.44). GC and GG + CG genotypes at rs1143623 reduced the risk of HBV-ACLF. There were only two GG and GT genotypes in rs1799983 in our study, and the genotype and allele frequency were statistically different between the death group and the survival group (P = 0.027, P = 0.023). Patients with T allele may reduce the risk of death in patients with HBV-ACLF. The genotype and allele frequency of rs2297518 showed no significant difference. In dominant models, patients with GA + AA genotypes at rs2297518 had a reduced risk of death.

Hepcidin and IL-1β

Hepcidin expression is determined through transcriptional regulation by systemic iron status. However, acute or chronic inflammation also increases the expression of hepcidin, which is associated with the dysregulation of iron metabolism in pathological conditions. Interleukin (IL)-6 has been suggested to be a principal molecule to confer inflammation-related hepcidin transcription, which is mediated via signal transducer and activator of transcription (STAT)-binding site on the hepcidin promoter. Recently, it has been uncovered that another pro-inflammatory cytokine IL-1β stimulates hepcidin expression through the distinct mechanism underlying IL-6-mediated hepcidin transcription. In addition to IL-6 induction, IL-1β stimulates expression of CCAAT-enhancer-binding protein (C/EBP)δ, a transcription factor, leading to transcriptional activation of hepcidin via C/EBP-binding site on the hepcidin promoter. Thus, hepcidin transcription is stimulated through multiple elements in response to proinflammatory cytokines. Relationships between increased production of IL-1β and dysregulated iron metabolism have been suggested in various diseases, which may be linked to overproduction of hepcidin.