title: Serum osteopontin levels in patients with acute liver dysfunction.
abstract: OBJECTIVE
  Fulminant hepatic failure (FHF) is a clinical syndrome of sudden and severe liver dysfunction accompanied by encephalopathy in a previously healthy person. In FHF, hepatocytes are severely damaged and ordinary liver regeneration is impaired. We demonstrated that the expression of osteopontin (OPN), a multifunctional cytokine, was up-regulated in mouse oval cell (a stem-cell progenitor) induction models.
  
  
  METHODS
  Based on this finding, serum OPN levels were examined in 43 patients with FHF and in 45 patients with acute self-limited hepatitis (AH). To determine the cellular source of OPN, the expression of OPN was studied in a liver specimen derived from an FHF patient.
  
  
  RESULTS
  The mean OPN level of patients with FHF was 2.80+/-0.48 ng/ml (log(10), +/-SD), which was significantly higher than that of the patients with AH (2.42+/-0.39 ng/ml) (p=0.003, unpaired t-test). Patients with elevated serum OPN levels had a significantly poorer prognosis than patients whose serum OPN levels were not elevated. In the FHF patient's liver, OPN protein was expressed not only in inflammatory cells but also in regenerating hepatocytes and bile ductular structures.
  
  
  CONCLUSIONS
  Our current study indicates that serum OPN levels increased in patients with FHF and that OPN might play an important role in liver regeneration due to activation of hepatic stem cells.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine Chiba University, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fukai
authors.forename: Fumio
authors.initials: F
authors.lastname: Imazeki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Muramatsu
authors.forename: Naohiko
authors.initials: N
authors.lastname: Seki
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirasawa
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology; D006505:Hepatitis / Q000097:blood; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000737:chemistry; D017114:Liver Failure, Acute / Q000097:blood* / Q000473:pathology; D008297:Male; D053495:Osteopontin; D011379:Prognosis; D012795:Sialoglycoproteins / Q000032:analysis / Q000097:blood*
chemical_list: C506895:SPP1 protein, human; D012795:Sialoglycoproteins; C506896:Spp1 protein, mouse; D053495:Osteopontin