Serum cytokeratin-18 fragment levels are useful biomarkers for nonalcoholic steatohepatitis in children

Ariel E. Feldstein, Naim Alkhouri, Rita De Vito, Anna Alisi, Rocio Lopez, Valerio Nobili

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Abstract

OBJECTIVES:Nonalcoholic steatohepatitis (NASH) is the most aggressive form of nonalcoholic fatty liver disease (NAFLD). Noninvasive methods to identify children with NASH are urgently needed. The aim of this study was to evaluate the use of plasma cytokeratin-18 (CK18) fragment levels, a marker of increased hepatocyte apoptosis, as a non-invasive biomarker for pediatric NASH.METHODS:Consecutive children with biopsy-proven NAFLD were included and blood samples were collected at the time of the biopsy. The diagnosis of NASH was based on Brunt's criteria. Histological features were scored: steatosis (0-3), lobular inflammation (0-3), ballooning (0-2), and portal inflammation (0-2). NAFLD activity score was calculated (0-8) and fibrosis stage was scored (0-4). We measured plasma CK18 levels using the M30-Apoptosense enzyme-linked immunosorbent assay kit.RESULTS:A total of 201 subjects were included in the study. The mean age was 10.7±2.5 years and 37% were male. NASH was diagnosed in 140 patients with a mean NAFLD activity scoring of 4.4±1.3. CK18 levels were significantly higher in subjects with NASH compared with not NASH (322.1 U/l±104.8 vs. 164.2 U/l±62, respectively; P

Original languageEnglish
Pages (from-to)1526-1531
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume108
Issue number9
DOIs
Publication statusPublished - Sep 2013

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Keratin-18
Biomarkers
Serum
Non-alcoholic Fatty Liver Disease
Inflammation
Biopsy
Hepatocytes
Fibrosis
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Serum cytokeratin-18 fragment levels are useful biomarkers for nonalcoholic steatohepatitis in children. / Feldstein, Ariel E.; Alkhouri, Naim; De Vito, Rita; Alisi, Anna; Lopez, Rocio; Nobili, Valerio.

In: American Journal of Gastroenterology, Vol. 108, No. 9, 09.2013, p. 1526-1531.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES:Nonalcoholic steatohepatitis (NASH) is the most aggressive form of nonalcoholic fatty liver disease (NAFLD). Noninvasive methods to identify children with NASH are urgently needed. The aim of this study was to evaluate the use of plasma cytokeratin-18 (CK18) fragment levels, a marker of increased hepatocyte apoptosis, as a non-invasive biomarker for pediatric NASH.METHODS:Consecutive children with biopsy-proven NAFLD were included and blood samples were collected at the time of the biopsy. The diagnosis of NASH was based on Brunt's criteria. Histological features were scored: steatosis (0-3), lobular inflammation (0-3), ballooning (0-2), and portal inflammation (0-2). NAFLD activity score was calculated (0-8) and fibrosis stage was scored (0-4). We measured plasma CK18 levels using the M30-Apoptosense enzyme-linked immunosorbent assay kit.RESULTS:A total of 201 subjects were included in the study. The mean age was 10.7±2.5 years and 37{\%} were male. NASH was diagnosed in 140 patients with a mean NAFLD activity scoring of 4.4±1.3. CK18 levels were significantly higher in subjects with NASH compared with not NASH (322.1 U/l±104.8 vs. 164.2 U/l±62, respectively; P",
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AU - Feldstein, Ariel E.

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AU - De Vito, Rita

AU - Alisi, Anna

AU - Lopez, Rocio

AU - Nobili, Valerio

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N2 - OBJECTIVES:Nonalcoholic steatohepatitis (NASH) is the most aggressive form of nonalcoholic fatty liver disease (NAFLD). Noninvasive methods to identify children with NASH are urgently needed. The aim of this study was to evaluate the use of plasma cytokeratin-18 (CK18) fragment levels, a marker of increased hepatocyte apoptosis, as a non-invasive biomarker for pediatric NASH.METHODS:Consecutive children with biopsy-proven NAFLD were included and blood samples were collected at the time of the biopsy. The diagnosis of NASH was based on Brunt's criteria. Histological features were scored: steatosis (0-3), lobular inflammation (0-3), ballooning (0-2), and portal inflammation (0-2). NAFLD activity score was calculated (0-8) and fibrosis stage was scored (0-4). We measured plasma CK18 levels using the M30-Apoptosense enzyme-linked immunosorbent assay kit.RESULTS:A total of 201 subjects were included in the study. The mean age was 10.7±2.5 years and 37% were male. NASH was diagnosed in 140 patients with a mean NAFLD activity scoring of 4.4±1.3. CK18 levels were significantly higher in subjects with NASH compared with not NASH (322.1 U/l±104.8 vs. 164.2 U/l±62, respectively; P

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