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Serum Apoptosis Markers in Acute Liver Failure: A Pilot Study

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1 Serum Apoptosis Markers in Acute Liver Failure: A Pilot Study
Anna E. Rutherford, Linda S. Hynan, Carolina B.S. Borges, David G. Forcione, Jason T. Blackard, Wenyu Lin, April R. Gorman, Obaid Shakil Shaikh, Adrian Reuben, Edwyn Harrison, K. Rajender Reddy, William M. Le, Raymond T. Chung  Clinical Gastroenterology and Hepatology  Volume 5, Issue 12, Pages (December 2007) DOI: /j.cgh Copyright © 2007 AGA Institute Terms and Conditions

2 Figure 1 Cytokine levels in ALF vs controls. Median values for TNF-α, HGF, and IL-6 were at least 10-fold higher in patients with ALF when compared with those with chronic HCV or healthy controls. In contrast, median sFas levels were more elevated in chronic HCV, which has been previously described.13,14 *P < for comparison between ALF and normal or HCV. **P < for comparison between HCV and normal or ALF. Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh ) Copyright © 2007 AGA Institute Terms and Conditions

3 Figure 2 Cytokine levels by etiology. Median day 1 and day 3 sFas along with day 1 HGF were all significantly higher in drug-induced liver injury as compared with other etiologies examined. *P = .004 for comparison between DILI and indeterminate or viral. **P = .011 for comparison between DILI and indeterminate or viral. ***P = .019 for comparison between DILI and indeterminate, viral, or acetaminophen. Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh ) Copyright © 2007 AGA Institute Terms and Conditions

4 Figure 3 (A) Median M-30 antigen levels by group. Median M-30 antigen levels for normal controls (104.7 U/L, range 86–206 U/L), chronic HCV (288.3 U/L, range 92–2265 U/L), and ALF (1686 U/L, range 230–15,590 U/L). P < for the 3-way comparison between ALF, HCV, and normal controls. (B) Median M-30 antigen levels by outcome. Median M-30 antigen levels were considerably lower in patients who spontaneously survived ( , range 230–15,590 U/L) when compared with those who were transplanted and/or died ( , range 536–15,590 U/L) (P = .026). Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh ) Copyright © 2007 AGA Institute Terms and Conditions

5 Figure 4 M-30 immunoreactivity in liver tissue. Expression of M-30 immunohistochemical staining on paraffin-embedded sections from liver tissue in ALF at 10× (A) and 40× (B) and in chronic HCV at 10× (C) and 40× (D). Clinical Gastroenterology and Hepatology 2007 5, DOI: ( /j.cgh ) Copyright © 2007 AGA Institute Terms and Conditions


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