title: Novel association between serum pentraxin-2 levels and advanced fibrosis in well-characterised patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Pentraxin-2 (PTX-2), a serum protein, inhibits inflammation and fibrosis, and recombinant PTX-2 is being tested as an anti-fibrotic agent.
  
  
  OBJECTIVE
  To evaluate the association between serum PTX-2 levels and fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  Serum pentraxin-2 levels were compared between four groups of well-characterised patients including NAFLD with no fibrosis, NAFLD with mild-moderate fibrosis (stage 1-2), NAFLD with advanced fibrosis (stage 3-4), and age-sex matched non-NAFLD controls.
  
  
  RESULTS
  Sixty subjects were included in the study. The mean age was 58.9 years, 68% were male and 58% were Caucasian. In univariate analysis, serum PTX-2 levels significantly decreased from non-NAFLD controls to mild NAFLD with no fibrosis, to NAFLD with mild-moderate fibrosis and were lowest in patients with NAFLD and advanced fibrosis, in a dose-dependent manner (P < 0.0001). In multivariable-adjusted analyses controlling for age, sex, albumin, and CRP, the results remained consistent and statistically significant. Serum PTX-2 level had an AUROC of 0.84 (95% CI: 0.71-0.97) for the diagnosis of NAFLD, and an AUROC of 0.77 (95% CI: 0.65-0.90) for the diagnosis of advanced fibrosis in NAFLD. Serum PTX-2 levels also decreased with increasing liver stiffness as estimated by magnetic resonance elastography (r = -0.31, P = 0.02).
  
  
  CONCLUSIONS
  PTX-2 levels are significantly lower in patients with NAFLD compared to non-NAFLD controls, and decline further in patients with advanced fibrosis. PTX-2 may therefore be both a biomarker of disease and a potential target for anti-fibrotic therapy with the recombinant pentraxin-2.
authors.affiliation: Center for Liver Disease and Transplantation, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: E C
authors.initials: EC
authors.lastname: Verna
authors.affiliation: Internal Medicine, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Patel
authors.affiliation: NAFLD Translational Research Unit, University of California at San Diego, La Jolla, CA, USA.|Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Bettencourt
authors.affiliation: NAFLD Translational Research Unit, University of California at San Diego, La Jolla, CA, USA.|Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nguyen
authors.affiliation: NAFLD Translational Research Unit, University of California at San Diego, La Jolla, CA, USA.|Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Hernandez
authors.affiliation: Department of Pathology, University of California at San Diego, La Jolla, CA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Valasek
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kisselva
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Brenner
authors.affiliation: NAFLD Translational Research Unit, University of California at San Diego, La Jolla, CA, USA.|Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.|Division of Epidemiology, Department of Family and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Loomba
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001798:Blood Proteins / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000150:complications*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001798:Blood Proteins