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2011, Number 2

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Ann Hepatol 2011; 10 (2)

Onset of heart failure determines the hepatic cell death pattern

Herzer K, Kneiseler G, Bechmann LP, Post F, Schlattjan M, Sowa, Jan-Peter, Neumann T, Marggraf G, Erbel R, Gerken G, Canbay A, Jochum C

Language: English
References: 16
Page: 174-179
PDF size: 156.99 Kb.


ABSTRACT

Background and rationale. Acute and chronic heart failure (HF) may affect the liver, but the underlying mechanisms that lead to progressive liver damage are poorly understood. The hepatic cytokeratin-18 (CK18) epitopes M65 and M30 have been reported to distinguish between overall (necrotic) and apoptotic cell death, respectively. We aimed to evaluate the predominant hepatic cell death pattern in acute vs. chronic heart failure and examined if these assays predict the course of the disease. Main results. In a prospective study comprising 21 patients with acute HF (AHF) and 18 patients with chronic HF (CHF) serum levels of M65 and M30 were assessed. Compared with CHF, M65 levels were significantly increased in patients with AHF (CHF: 1,283 ± 591.6U/l vs. AHF: 20,912 ± 15,132U/l, p ‹ 0.001). In addition, M30 levels were significantly increased in AHF (CHF: 642.2 ± 177.4U/l vs. AHF: 3,844 ± 5,293U/l, p ‹ 0.05), but the M30/M65 ratio was significantly higher in CHF (CHF: 0.54 ± 0.15 vs. AHF: 0.20 ± 0.19, p ‹ 0.001), indicating a greater contribution of apoptotic cell death in CHF. AHF patients with higher M30 values had a worse prognosis. Conclusions. The ratio of CK18 M30/M65 is a potential marker to discriminate AHF from CHF induced LF and M30 might be a prognostic marker for survival in AHF induced liver injury.


REFERENCES

  1. Canbay A, Jochum C, Bechmann LP, et al. Acute liver failure in a metropolitan area in Germany: a retrospective study (2002-2008). Z Gastroenterol 2009: 47: 807-13.

  2. Kubo SH, Walter BA, John DH, Clark M, Cody RJ. Liver function abnormalities in chronic heart failure. Influence of systemic hemodynamics. Arch Intern Med 1987: 147: 1227-30.

  3. Moller S, Dumcke CW, Krag A. The heart and the liver. Expert Rev Gastroenterol Hepatol 2009: 3: 51-64.

  4. Batin P, Wickens M, McEntegart D, Fullwood L, Cowley AJ. The importance of abnormalities of liver function tests in predicting mortality in chronic heart failure. Eur Heart J 1995: 16: 1613-8.

  5. Seeto RK, Fenn B, Rockey DC. Ischemic hepatitis: clinical presentation and pathogenesis. Am J Med 2000: 109: 109-13.

  6. Bechmann LP, Jochum C, Kocabayoglu P, et al. Cytokeratin 18-based modification of the MELD score improves prediction of spontaneous survival after acute liver injury. J Hepatol 2010: 53: 639-47.

  7. Marcucci R, Gori AM, Giannotti F, et al. Markers of hypercoagulability and inflammation predict mortality in patients with heart failure. J Thromb Haemost 2006: 4: 1017-22.

  8. Senturk T, Aydinlar A, Yilmaz Y, Oral AY, Ozdabakoglu O, Ulukaya E. Serial changes in circulating M30 antigen, a biomarker of apoptosis, in patients with acute coronary syndromes: relationship with the severity of coronary artery disease. Coron Artery Dis 2009: 20: 494-8.

  9. Adlbrecht C, Hoetzenecker K, Posch M, et al. Elevated levels of interleukin-1beta-converting enzyme and caspasecleaved cytokeratin-18 in acute myocardial infarction. Eur J Clin Invest 2007: 37: 372-80.

  10. Mattey DL, Dawes PT, Nixon NB, Goh L, Banks MJ, Kitas GD. Increased levels of antibodies to cytokeratin 18 in patients with rheumatoid arthritis and ischaemic heart disease. Ann Rheum Dis 2004: 63: 420-5.

  11. Soleiman A, Lukschal A, Hacker S, et al. Myocardial lipofuscin- laden lysosomes contain the apoptosis marker caspase- cleaved cytokeratin-18. Eur J Clin Invest 2008: 38: 708-12.

  12. Dechene A, Sowa JP, Gieseler RK, et al. Acute liver failure is associated with elevated liver stiffness and hepatic stellate cell activation. Hepatology 2010: 52: 1008-16.

  13. Hetz H, Hoetzenecker K, Hacker S, et al. Caspase-cleaved cytokeratin 18 and 20 S proteasome in liver degeneration. J Clin Lab Anal 2007: 21: 277-81.

  14. Lebray P, Varnous S, Charlotte F, Varaut A, Poynard T, Ratziu V. Liver stiffness is an unreliable marker of liver fibrosis in patients with cardiac insufficiency. Hepatology 2008: 48: 2089

  15. Millonig G, Friedrich S, Adolf S, et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol 2010:52: 206-10.

  16. Bechmann LP, Gieseler RK, Sowa JP, et al. Apoptosis is associated with CD36/fatty acid translocase upregulation in non-alcoholic steatohepatitis. Liver Int 2010: 30: 850-9.




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