title: Serum Autotaxin is a Marker of the Severity of Liver Injury and Overall Survival in Patients with Cholestatic Liver Diseases.
abstract: Autotaxin (ATX) is involved in the synthesis of lysophosphatidic acid. Both have recently been linked to cholestatic pruritus and liver injury. We aimed to investigate whether ATX is an indicator of cholestatic liver injury, health-related quality of life (HRQoL) and prognosis based on a group of 233 patients, 118 with primary biliary cholangitis (PBC) and 115 with primary sclerosing cholangitis (PSC). Patients were followed for 1-60 months, cumulative survival rates were calculated. ATX activity was significantly higher in both groups than in the 103 controls, particularly in patients with cirrhosis and in patients with longer disease duration. Ursodeoxycholic acid (UDCA) non-responders with PBC exhibited increased ATX activity. ATX activity was correlated with liver biochemistry, MELD, Mayo Risk scores and was associated with worse disease-specific HRQoL aspects. In both groups, Cox model analysis indicated that ATX was a negative predictor of survival. Increased ATX levels were associated with a 4-fold higher risk of death/liver transplantation in patients with PBC and a 2.6-fold higher risk in patients with PSC. We conclude that in patients with cholestatic conditions, ATX is not only associated with pruritus but also indicates impairment of other HRQoL aspects, liver dysfunction, and can serve as a predictor of survival.
authors: Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
authors: Ewa
authors: E
authors: Wunsch
authors: Department of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, Germany.|Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland.
authors: Marcin
authors: M
authors: Krawczyk
authors: Department of Medical Biology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
authors: Malgorzata
authors: M
authors: Milkiewicz
authors: Laboratory of Molecular Pharmacology, CHU-de-Québec &Faculty of Pharmacy, Laval University, 2705 Québec, QC, Canada.
authors: Jocelyn
authors: J
authors: Trottier
authors: Laboratory of Molecular Pharmacology, CHU-de-Québec &Faculty of Pharmacy, Laval University, 2705 Québec, QC, Canada.
authors: Olivier
authors: O
authors: Barbier
authors: Department of Medicine I, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany.
authors: Markus F
authors: MF
authors: Neurath
authors: Department of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, Germany.
authors: Frank
authors: F
authors: Lammert
authors: Department of Medicine I, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany.
authors: Andreas E
authors: AE
authors: Kremer
authors: Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.|Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery of the Medical University of Warsaw, 02-097 Warsaw, Poland.
authors: Piotr
authors: P
authors: Milkiewicz
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000378:metabolism*; D002779:Cholestasis / Q000097:blood / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000378:metabolism*; D008246:Lysophospholipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010727:Phosphoric Diester Hydrolases / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011537:Pruritus / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D011788:Quality of Life; D012720:Severity of Illness Index; D016019:Survival Analysis; D055815:Young Adult; D000099189:Lysophospholipase D
chemical_list: D015415:Biomarkers; D008246:Lysophospholipids; D010727:Phosphoric Diester Hydrolases; D000099189:Lysophospholipase D; C032881:lysophosphatidic acid