Blood Biomarkers of Intestinal Epithelium Damage Regenerating Islet‐derived Protein 3α and Trefoil Factor 3 Are Persistently Elevated in Patients with Alcoholic Hepatitis. (11th March 2021)

• Record Type: Journal Article
• Authors: Yang, Jing; Syed, Fahim; Xia, Ying; Sanyal, Arun J.; Shah, Vijay H.; Chalasani, Naga; Zheng, Xiaoqun; Yu, Qigui; Lou, Yongliang; Li, Wei
• Is Part Of: Alcoholism. Volume 45:Number 4(2021)
• Page Start: 720
• Page End: 731
• Publication Date: 2021-03-11
• Subjects: REG3α -- TFF3 -- Alcoholic Hepatitis -- Gut Epithelial Damage -- Microbial Translocation -- Inflammation -- Immune Activation; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.14579
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract : Background: Heavy alcohol consumption disrupts gut epithelial integrity, leading to increased permeability of the gastrointestinal tract and subsequent translocation of microbes. Regenerating islet‐derived protein 3α (REG3α) and Trefoil factor 3 (TFF3) are mainly secreted to the gut lumen by Paneth and Goblet cells, respectively, and are functionally linked to gut barrier integrity. Circulating levels of REG3α and TFF3 have been identified as biomarkers for gut damage in several human diseases. We examined whether plasma levels of REG3α and TFF3 were dysregulated and correlated with conventional markers of microbial translocation (MT) and pro‐inflammatory mediators in heavy drinkers with and without alcoholic hepatitis (AH). Methods: Cross‐sectional and longitudinal studies were performed to monitor plasma levels of REG3α and TFF3 in 79 AH patients, 66 heavy drinkers without liver disease (HDC), and 46 healthy controls (HC) at enrollment and at 6‐ and 12‐month follow‐ups. Spearman correlation was used to measure the relationships of REG3α and TFF3 levels with MT, disease severity, inflammation, and effects of abstinence from alcohol. Results: At enrollment, AH patients had significantly higher levels of REG3α and TFF3 than HDC and HC. The elevated REG3α levels were positively correlated with the 30‐day fatality rate. Plasma levels of REG3α and TFF3 in AH patients differentially correlated with conventional MT markers (sCD14, sCD163, and LBP) and several highly up‐regulated inflammatory cytokines/chemokines/growth factors. At follow‐ups, although REG3α and TFF3 levels were decreased in AH patients with alcohol abstinence, they did not fully return to baseline levels. Conclusions: Circulating levels of REG3α and TFF3 were highly elevated in AH patients and differentially correlated with AH disease severity, MT, and inflammation, thereby serving as potential biomarkers of MT and gut epithelial damage in AH patients. Abstract : Alcohol abuse disrupts gut epithelial integrity, leading to microbial translocation (MT) and inflammation. This study showed that two blood biomarkers of intestinal epithelium damage, REG3α and TFF3, were persistently elevated in patients with alcoholic hepatitis (AH), but not in heavy drinking controls without overt liver disease (HDC). Plasma REG3α and TFF3 levels were differentially correlated with AH disease severity, several conventional MT markers, and inflammation, thereby potentially serving as novel biomarkers of MT and gut epithelial damage in AH patients.