title: Activin A and follistatin in acute liver failure.
abstract: BACKGROUND
  Liver regeneration may be impaired in acute liver failure due to either inhibition of the proliferative response or ongoing liver cell death. Activin A, a member of the TGFbeta superfamily, inhibits hepatocyte DNA synthesis and induces apoptosis.
  
  
  METHODS
  Levels of activin A and its binding protein follistatin in the serum of 23 patients with acute liver failure were determined by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Serum activin A was significantly increased in acute liver failure patients (median 2.15 ng/ml, range 0.28-6.87 ng/ml) compared to normal controls (median 0.25 ng/ml, range 0.19-0.53 ng/ml; = 10; 0.001). However, this was not linked to the final disease outcome. Higher levels of activin A were found in the serum of patients with acute liver failure due to paracetamol overdose (median 2.87 ng/ml, range 0.72-6.87 ng/ml; = 17) than in patients with acute liver failure due to non-A to E hepatitis (median 1.10 ng/ml, range 0.28-2.70 ng/ml; = 6; 0.05). Serum follistatin was also increased in acute liver failure patients (median 2.84 ng/ml, range 0.57-13.24 ng/ml) compared to normal controls (median 0.68 ng/ml, range 0.32-3.70 ng/ml; 0.01).
  
  
  CONCLUSIONS
  Serum activin A is increased in acute liver failure and could be a factor in the inhibition of liver regeneration.
authors.affiliation: Institute of Liver Studies, Guy's, King's & St Thomas' School of Medicine, King's College Denmark Hill Campus, Bessemer Road, London SE5 9PJ, UK. robin.hughes@kcl.ac.uk
authors.forename: Robin D
authors.initials: RD
authors.lastname: Hughes
authors.forename: Lee W
authors.initials: LW
authors.lastname: Evans
mesh_terms: D000082:Acetaminophen / Q000506:poisoning; D028341:Activins / Q000097:blood*; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D038681:Follistatin / Q000097:blood*; D006505:Hepatitis / Q000150:complications; D006801:Humans; D028322:Inhibin-beta Subunits / Q000097:blood*; D017114:Liver Failure, Acute / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013936:Thymidine / Q000378:metabolism; D016212:Transforming Growth Factor beta / Q000097:blood; D014407:Tumor Cells, Cultured
chemical_list: D018712:Analgesics, Non-Narcotic; D015415:Biomarkers; D038681:Follistatin; D016212:Transforming Growth Factor beta; C422405:activin A; D028341:Activins; D000082:Acetaminophen; D028322:Inhibin-beta Subunits; D013936:Thymidine