Activin A and follistatin in acute liver failure.
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.
Hughes
Robin D
RD
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
Evans
Lee W
LW
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
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