Characteristics of Serum Hyaluronate Concentrations in Patients with Alcoholic Liver Disease

Abstract

It has been reported that serum hyaluronate [hyaluronic acid (HA)] concentrations are increased in liver diseases, especially in alcoholic liver disease (ALD). However, the characteristics of serum HA concentration in patients with ALD have not been studied. In this study, first, we measured serum HA concentrations in patients with different stages of both ALD and non-ALD to clarify the characteristics of serum HA concentration in patients with ALD. Second, we measured serum HA concentrations in patients with ALD sequentially after abstinence. We also measured serum HA concentrations in patients with chronic type C hepatitis before and after treatment with interferon. Finally, we analyzed the relationship between serum HA concentrations and the contents of type IV collagen and laminin in the livers of both ALD and non-ALD patients. Serum HA concentrations in liver disease were higher than the cut-off value, and increased significantly (p < 0.001) in parallel with the progression of hepatic fibrosis in both ALD and non-ALD patients. Serum HA concentrations in patients actively drinking with ALD were significantly higher (p < 0.001) than those in non-ALD. After 4 weeks of abstinence, these concentrations fell to the levels of non-ALD. Although serum ALT levels were decreased in 80% of patients treated with interferon, serum HA concentrations were not changed or increased. A significant correlation between serum HA concentrations and hepatic type IV collagen and laminin content was present in ALD, but not in non-ALD. These results clearly suggest that the increase of serum HA concentrations in ALD may be associated with not only hepatic fibrosis, but also alcohol drinking.

Accuracy of the Enhanced Liver Fibrosis Test vs FibroTest, Elastography, and Indirect Markers in Detection of Advanced Fibrosis in Patients With Alcoholic Liver Disease

“…[40][41][42] Although drinking pattern did not predict ELF, FibroTest, or elastography in our study, other studies indicate that active alcohol abuse may increase risk of false positives. 17,36 However, our biopsy-controlled data suggest that hepatic inflammation and cholestatic liver injury influence the noninvasive markers, rather than alcohol in itself. Fibrosis stage, histological inflammation, alkaline phosphatase, and bilirubin independently predicted ELF, FibroTest, and elastography.…”

“…We chose the predictors that prior publications suggested may influence ELF and other noninvasive tests. 9,17,36 Finally, we used the net reclassification index to test whether there was any incremental value of using ELF instead of, or in combination with, other fibrosis markers. 37 We analyzed the net reclassification for ELF vs indirect serum indices in patients recruited from primary health care; and of ELF vs TE in patients recruited from secondary health care.…”

Index serum hyaluronic acid independently and accurately predicts mortality in patients with liver disease

“…Alcohol status was also not controlled for due to the difficulties of accurately quantifying consumption retrospectively. Ongoing alcohol use has been independently associated with higher hyaluronic acid levels and may have influenced the higher values observed in the ALD group (Figure ) . However, the patients with ALD had higher MELD scores as well as mortality compared to other aetiologies (Figure , Figure S3).…”

Serum hyaluronan as a predictor of hepatic regeneration after hepatectomy in humans

“…Serum HA levels are also involved in the function of hepatic sinusoidal endothelial cells, because more than 90% of the circulating HA is degraded in hepatic sinusoidal endothelial cells [14,15]. The increase in the serum HA level is also reported to be associated with alcohol drinking, which is probably due to reversible sinusoidal capillarization caused by alcohol [30,31]. In the cirrhotic liver, the function of sinusoidal endothelial cells is closely related to hepatic sinusoidal capillarization [14,15].…”