Prognostic role of the stromal cell derived factor-1 in patients with hepatitis B virus-related acute-on-chronic liver failure.

Background: Stromal cell derived factor-1 (SDF-1) plays a pivotal role in the recruitment of stem cells to injured livers. However, the changes of SDF-l in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) have yet to be elucidated.

Aim: To study the SDF-1 changes in patients with HBV-related ACLF.

Methods: 30 patients with HBV-related ACLF, 27 patients with chronic hepatitis B and 20 healthy individuals are involved in our study. The SDF-l mRNA expression in liver tissue was detected by quantitative real-time polymerase chain reaction. Immunohistochemical staining was performed to illustrate the expression of SDF-l, CXC receptor 4 (CXCR4) and Ki67. The serum SDF-l concentrations were also detected by enzyme-linked immunosorbent assays.

Results: The expression of SDF-1 mRNA from ACLF patients was remarkably higher than that from other patients (both < 0.05). The expression of SDF-l, CXCR4 and Ki67 from ACLF were the highest among the three groups (all < 0.01). The serum SDF-l levels in ACLF patients were significantly lower than that in other patients (both < 0.01). Moreover, in ACLF patients, the serum SDF-1 Levels were positively correlated with serum total bilirubin and international normalized ratio. In addition, the serum SDF-l levels in survival were significantly lower compared with the non-survivals ( < 0.05). The area under the curve for the serum SDF-1 level in predicting 28-d mortality was 0.722 ( < 0.05).

Conclusion: This study provides the SDF-1 changes in patients with HBV-related ACLF. The SDF-1 Level at admission may serve as a promising prognostic marker for predicting short-term prognosis.