Plasma YKL-40: A New Potential Marker of Fibrosis in Patients with Alcoholic Cirrhosis?

J. S. Johansen Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

S. Møller Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

P. A. Price Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

F. Bendtsen Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

J. Junge Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

C. Garbarsch Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

J. H. Henriksen Dept. of Medicine, Division of Rheumatology and Division of Medical Gastroenterology, Dept. of Clinical Physiology and Nuclear Medicine, and Dept. of Pathology, Hvidovre Hospital, University of Copenhagen, Hvidore; Dept. of Anatomy A, Panum Institute, University of Copenhagen, Copenhagen, Denmark; Dept. of Biology 0322, University of California, San Diego, La Jolla, California, USA

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Abstract

Background: YKL-40 (human cartilage glycoprotein-39, or 38-kDa heparin-binding glycoprotein) is a mammalian member of a protein family that includes bacterial chitinases. YKL-40 mRNA is expressed by human liver and may play a role in tissue remodelling. The aims were to assess whether circulating YKL-40 is released or extracted in the hepatosplanchnic system and to localize YKL-40 in liver tissue. Methods: Plasma YKL-40 was determined by radioimmunoassay in 25 patients with liver diseases (alcoholic cirrhosis (n=20), chronic active hepatitis (n = 2), cirrhosis of unknown aetiology (n=2), and fatty liver (H=1)) and in 18 subjects with normal liver function during a haemodynamic investigation with catheterization of liver vein and the femoral artery. Immunohistochemical studies of the localization of YKL-40 in cryostat liver biopsy specimens were obtained from eight other patients with alcoholic liver disease. Results: Plasma YKL-40 was significantly increased in patients with alcoholic cirrhosis (median, 523 μg/l; P< 0.001) compared with controls (106μg/l), and plasma YKL-40 in the hepatic vein was higher (P < 0.01) than that of the artery in both the patients and controls, showing release of YKL-40 from the hepatosplanchnic area. The release rate of YKL-40 from the hepatosplanchnic area was higher in patients with liver disease than in controls (11.0 versus 2.1 μg/min, P < 0.05). Furthermore, the highest plasma YKL-40 levels were found in patients with a moderate or severe degree of liver fibrosis, and immunohistochemical studies showed positive staining for YKL-40 antigen in areas of the liver biopsy with fibrosis. Conclusions: The increased plasma YKL-40 in patients with alcoholic cirrhosis may reflect the remodelling of liver fibrosis.

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Plasma YKL-40: A New Potential Marker of Fibrosis in Patients with Alcoholic Cirrhosis?

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Plasma YKL-40: A New Potential Marker of Fibrosis in Patients with Alcoholic Cirrhosis?

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