title: Plasma osteopontin in acute liver failure.
abstract: BACKGROUND
  Osteopontin (OPN) is a novel phosphoglycoprotein expressed in Kupffer cells that plays a pivotal role in activating natural killer cells, neutrophils and macrophages. Measuring plasma OPN levels in patients with acute liver failure (ALF) might provide insights into OPN function in the setting of massive hepatocyte injury.
  
  
  METHODS
  OPN levels were measured using a Quantikine® ELISA assay on plasma from 105 consecutive ALF patients enrolled by the US Acute Liver Failure Study Group, as well as controls including 40 with rheumatoid arthritis (RA) and 35 healthy subjects both before, and 1 and 3 days after undergoing spine fusion (SF) surgery as a model for acute inflammation.
  
  
  RESULTS
  Median plasma OPN levels across all etiologies of ALF patients were elevated 10- to 30-fold: overall median 1055ng/mL; range: 33-19,127), when compared to healthy controls (median in pre-SF patients: 41ng/mL; range 2.6-86.4). RA and SF post op patients had elevated OPN levels (37ng/mL and 198ng/mL respectively), well below those of the ALF patients. Median OPN levels were highest in acetaminophen (3603ng/mL) and ischemia-related ALF (4102ng/mL) as opposed to viral hepatitis (706ng/mL), drug-induced liver injury (353ng/mL) or autoimmune hepatitis (436ng/mL), correlating with the degree of hepatocellular damage, as reflected by aminotransferase values (R value: 0.47 for AST, p<0.001).
  
  
  CONCLUSIONS
  OPN levels appeared to correlate with degree of liver necrosis in ALF. Very high levels were associated with hyperacute injury and good outcomes. Whether OPN exerts a protective effect in limiting disease progression in this setting remains uncertain.
authors: Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
authors: Praveen
authors: P
authors: Srungaram
authors: Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
authors: Jody A
authors: JA
authors: Rule
authors: Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
authors: He Jun
authors: HJ
authors: Yuan
authors: Rheumatology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
authors: Andreas
authors: A
authors: Reimold
authors: Spine Unit, Rigshospitalet, Copenhagen, Denmark.
authors: Benny
authors: B
authors: Dahl
authors: Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
authors: Corron
authors: C
authors: Sanders
authors: Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States. Electronic address: william.lee@utsouthwestern.edu.
authors: William M
authors: WM
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000097:blood; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood; D006801:Humans; D017114:Liver Failure, Acute / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors; D013123:Spinal Fusion; D055815:Young Adult
chemical_list: D053495:Osteopontin
keywords: Acute liver failure; Cytokine; Inflammation; Liver necrosis