Utility of Mac‐2 Binding Protein Glycosylation Isomer to Evaluate Graft Status After Liver Transplantation

Abstract

Mac‐2 binding protein glycosylation isomer (M2BPGi) is a novel liver fibrosis biomarker, but there are few studies on M2BPGi in liver transplantation (LT) recipients. This study aimed to evaluate the utility of M2BPGi measurement in LT recipients. We collected the clinicopathological data of 233 patients who underwent a liver biopsy at Kyoto University Hospital after LT between August 2015 and June 2019. The median values of M2BPGi in patients with METAVIR fibrosis stages F0, F1, F2, and ≥F3 were 0.61, 0.76, 1.16, and 1.47, respectively, whereas those in patients with METAVIR necroinflammatory indexes A0, A1, and ≥A2 were 0.53, 1.145, and 2.24, respectively. Spearman rank correlation test suggested that the necroinflammatory index had a stronger correlation to the M2BPGi value than the fibrosis stage. The area under the receiver operating characteristic curve of M2BPGi to predict ≥A1 was 0.75, which was significantly higher than that of any other liver fibrosis and inflammation marker. Patients with a rejection activity index (RAI) of ≥3 had a higher M2BPGi value than those with RAI ≤ 2 (P = 0.001). Patients with hepatitis C virus viremia had a higher M2BPGi value than sustained virological responders or those with other etiologies. In conclusion, the present study demonstrated that M2BPGi values are more strongly influenced by necroinflammatory activity and revealed M2BPGi, which has been thought to be a so‐called fibrosis marker, as a disease activity marker in transplant recipients. M2BPGi measurement may be useful to detect early stage liver inflammation that cannot be detected by routine blood examination of LT recipients.

New quantitative measurement system for M2BPGi reveals liver inflammation complicates liver cirrhosis diagnosis

“…Before conducting the clinical study, we assumed the in uence of liver in ammation on M2BPGi levels as previously reported [12]. Kimura et al reported a positive correlation between M2BPGi level and necroin ammatory activity and stated that M2BPGi can be used to assess the degree of liver in ammation in patients with liver diseases [12].…”

Bile acid profiles in adult patients with biliary atresia who achieve native liver survival after portoenterostomy

“…Therefore, it is possible that only GCDCA was correlated with M2BPGi in this study, because adult patients with biliary atresia with normalized bilirubin levels had only slight bile acid congestion. Recently, M2BPGi has been shown to be sensitive to the degree of liver inflammation 14 . Whether bile acids themselves are correlated with the degree of liver fibrosis or potentially contribute to liver damage remains controversial 2 .…”

Novel Noninvasive Biomarkers in Liver Transplantation: A Tool on the Doorstep of Clinical Utilization

“…Assessment of liver fibrosis is one such important scenario, particularly in the setting of early injury and rejection. Recently, Kimura et al 24 identified Mac-2 binding protein glycosylation isomer as a serological marker of postliver transplant fibrosis and disease activity that closely correlated with liver histology. In the pediatric population, serum levels of tissue inhibitor of matrix metalloproteinase-1 and the AST-to-platelet ratio index have been shown as accurate predictor of allograft fibrosis, serving as complementary tools to invasive biopsy.…”