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Serum Autotaxin Is a Useful Disease Progression Marker in Patients with Primary Biliary Cholangitis #MMPMID29802350
Joshita S; Umemura T; Usami Y; Yamashita Y; Norman GL; Sugiura A; Yamazaki T; Fujimori N; Kimura T; Matsumoto A; Igarashi K; Yoshizawa K; Ota M; Tanaka E
Sci Rep 2018[]; 8 (ä): ä PMID29802350show ga
Autotaxin (ATX) is a secreted enzyme metabolized by liver sinusoidal endothelial cells that has been associated with liver fibrosis. We evaluated serum ATX values in 128 treatment-naïve, histologically assessed primary biliary cholangitis (PBC) patients and 80 healthy controls for comparisons of clinical parameters in a case-control study. The median ATX concentrations in controls and PBC patients of Nakanuma?s stage I, II, III, and IV were 0.70, 0.80, 0.87, 1.03, and 1.70?mg/L, respectively, which increased significantly with disease stage (r?=?0.53, P?0.0001) as confirmed by Scheuer?s classification (r?=?0.43, P?0.0001). ATX correlated with Wisteria floribunda agglutinin-positive Mac-2 binding protein (M2BPGi) (r?=?0.51, P?0.0001) and fibrosis index based on four factors (FIB-4) index (r?=?0.51, P?0.0001). While ALP and M2BPGi levels had decreased significantly (both P?0.001) by 12 months of ursodeoxycholic acid treatment, ATX had not (0.95 to 0.96?mg/L) (P?=?0.07). We observed in a longitudinal study that ATX increased significantly (P?0.00001) over 18 years in an independent group of 29 patients. Patients succumbing to disease-related death showed a significantly higher ATX increase rate (0.05?mg/L/year) than did survivors (0.02?mg/L/year) (P?0.01). ATX therefore appears useful for assessing disease stage and prognosis in PBC.