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Sukriti S, Maras JS, Bihari C, Das S, Vyas AK, Sharma S, Hussain S, Shasthry S, Choudhary A, Premkumar M, Kumar D, Kumar G, Mukhopadhyay C, Kumar A, Trehanpati N, Rautou PE, Moreau R, Sarin SK. Microvesicles in hepatic and peripheral vein can predict nonresponse to corticosteroid therapy in severe alcoholic hepatitis. Aliment Pharmacol Ther 2018; 47:1151-1161. [PMID: 29460445 DOI: 10.1111/apt.14564] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/08/2017] [Accepted: 01/22/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe alcoholic hepatitis patients have high mortality and limited response to corticosteroids. Microvesicles reflect cellular stress and disease conditions. AIMS To investigate whether microvesicles are associated with severity, response to steroid therapy and inflammation in severe alcoholic hepatitis. METHODS Microvesicles originating from different cells were studied pre-therapy in 101 patients; (71 responder to corticosteroid therapy and 30 nonresponders) and 20 healthy controls. Microvesicles and cells were determined in peripheral and hepatic vein samples using flow cytometry and correlated with outcomes. Inflammatory signalling pathways and functional alterations of immune cells after stimulation with microvesicles were also investigated. RESULTS Microvesicles mean levels were higher in nonresponders for T cells (CD3+ CD4+ ; 10.1 MV/μL vs 5.4; P = 0.06), macrophages (CD68+ CD11b+ ; 136.5 vs 121.9 MV/μL; P = 0.01), haematopoietic stem-cells (CD45+ CD34+ ; 116.8 vs 13.4 MV/μL; P = 0.0001) and hepatocytes (ASGPR+ ; 470 vs 361 MV/μL; P = 0.01); the latter two predicting steroid nonresponse in 94% patients at baseline in peripheral plasma. Microvesicle levels correlated with histological and liver disease severity indices. Whereas, in non-responders hepatic vein CD34+ cells were lower (P = 0.02), the CD34+ microvesicles there from were higher (P = 0.04), thus suggesting impaired regeneration. Also, microvesicles of 0.2-0.4 μm size were higher in nonresponders (P < 0.03) at baseline. Microvesicles from patients trigger more (P = 0.04) ROS generation, TNF-α production (P = 0.04) and up-regulate pro-inflammatory cytokine related genes in neutrophils in vitro. CONCLUSIONS Pre-therapy peripheral plasma levels of CD34+ and ASGPR+ microvesicles are reliable non-invasive markers of steroid nonresponse and mortality in patients with severe alcoholic hepatitis.
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Affiliation(s)
- S Sukriti
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - J S Maras
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - C Bihari
- Department of Pathology, Institute of Liver and Biliary Sciences, Delhi, India
| | - S Das
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - A K Vyas
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - S Sharma
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - S Hussain
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - S Shasthry
- Department of Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
| | - A Choudhary
- Department of Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
| | - M Premkumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
| | - D Kumar
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - G Kumar
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - C Mukhopadhyay
- Special center for molecular medicine, JNU, Delhi, India
| | - A Kumar
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - N Trehanpati
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India
| | - P E Rautou
- Department of Hepatology, Hopital Beaujon, INSERM U970, University of Paris, Paris, France
| | - R Moreau
- Center for Research on Inflammation, Xavier Bichat School of Medicine, INSERM U1149, Paris-Diderot University, Paris, France
| | - S K Sarin
- Department of Molecular and cellular medicine, Institute of Liver and Biliary Sciences, Delhi, India.,Department of Hepatology, Institute of Liver and Biliary Sciences, Delhi, India
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Uddin M, Sukriti S, Desai B, Malik A, Ludwig A, Mehta D. ADAM 17 Regulates S1PR1 Surface Expression by its Ectodomain Shedding thereby Disrupting Endothelial Barrier Function. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.627.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mohammad Uddin
- Department of PharmacologyUniversity Of IllinoisChicagoILUnited States
| | - S Sukriti
- Department of PharmacologyUniversity Of IllinoisChicagoILUnited States
| | - Bhushan Desai
- Department of PharmacologyUniversity Of IllinoisChicagoILUnited States
| | - Asrar Malik
- Department of PharmacologyUniversity Of IllinoisChicagoILUnited States
| | - Andreas Ludwig
- Institute of Pharmacology and ToxicologyRWTH Aachen UniversityGermany
| | - Dolly Mehta
- Department of PharmacologyUniversity Of IllinoisChicagoILUnited States
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