The serum Arginase-1 correlation to child-pugh scores in predicting the severity of cirrhosis

Siti Muchayat Purnamaningsih

Siti Muchayat Purnamaningsih
Departement of Clinical Pathology and Laboratory Medicine , Faculty of Medicine, Gadjah Mada University of Yogyakarta. Email: [email protected]
Online First: August 03, 2017 | Cite this Article
Purnamaningsih, S. 2017. The serum Arginase-1 correlation to child-pugh scores in predicting the severity of cirrhosis. Bali Medical Journal 6(3): 606-610. DOI:10.15562/bmj.v6i3.685

Background: The Child-Pugh score is an internationally accepted system for grading the severity of chronic liver disease such as cirrhosis. It assesses the severity of the liver disease to avoid subjectivity and inconsistency. However, some non-invasive serological markers may also be useful to evaluate the stage of liver fibrosis in determining the severity of cirrhosis. Some of the known markers are Arginase-1 (ARG-1), IL-13, fibronectin (FN), tissue inhibitor of metalloproteinases-1 (TIMP-1), and metalloproteinases-1 (MMP-1). Objective: To evaluate the correlation between the circulating levels of ARG-1, IL-13, FN, TIMP-1, MMP-1 with the score Child-Pugh in cirrhosis patients. Materials and Methods: We conducted a cross-sectional study enrolling fifty-six patients of the chronic liver with Child-Pugh A, B, and C. The score was calculated based on the value of serum bilirubin, serum albumin, internationalized normal ratio (INR), and the severity of ascites and hepatic encephalopathy. Serum ARG-1, IL-13, FN, TIMP-1, MMP-1 were analyzed using an enzyme-linked immune sorbent assay. The differences were analyzed using Mann-Whitney test, Spearman’s correlation (univariate analysis), and multivariate analysis by the multi-regression test. Results: There was a significant correlation of ARG-1 serum with Child-Pugh scores (r = -0.589, p<0.05). However, we did not find a significant correlation between the Child-Pugh scores and the IL-13 (r=0.238, p=0.078), FN (r=-0.151, p=0.265), TIMP-1 (r=-0.158, p=0.244), and MMP-1 (r = -0.006, p = 0.967) with the Child-Pugh scores. Conclusion: The serum marker of ARG-1 was found correlated with the severity of the chronic liver disease.


Bataller R.and Brenner DA.. Liver fibrosis. J Clin Invest, 2005;115: 209–218.2. World Health Organization, Reducing Risks, Promoting Healthy Life. Geneva, WHO. 1–230.2002; 1–230. 3. S.L. Friedman, Liver fibrosis – from bench to bedside, J Hepatol , 2003; 38(Suppl 1); S38–S53.4. Bonacchi A, et al. The chemokine CCL21 modulates lymphocyte recruitment and fibrosis inchronic hepatitis C. Gastroenterology. 2003; 125:1060–76.

Miura K, et al. Toll-like receptor 9 promotes steatohepatitis by induction of interleukin-1betain mice. Gastroenterology. 2010; 139:323–34. e7.6. Karin M, Ben-Neriah Y. Phosphorylation meets ubiquitination: the control of NF-[kappa]Bactivity. Annu Rev Immunol. 2000; 18:621–63.7. Xiao C, Ghosh S. NF-kappaB, an evolutionarily conserved mediator of immune andinflammatory responses. Adv Exp Med Biol. 2005; 560:41–5.8. Luedde T, et al. IKK1 and IKK2 cooperate to maintain bile duct integrity in the liver. ProcNatl Acad Sci US A. 2008; 105:9733–97389. Kosters A, Karpen SJ. The role of inflammation in cholestasis: clinical and basic aspects.Semin Liver Dis. 2010; 30:186–9410.Karin M. NF-kappaB as a critical link between inflammation and cancer. Cold Spring HarbPerspect Biol. 2009; 1:a000141.11.Wasmuth HE, Tacke F, Trautwein C. Chemokines in liver inflammation and fibrosis. SeminLiverDis. 2010; 30:215–25.12.Inokuchi S, et al. Disruption of TAK1 in hepatocytes causes hepatic injury, inflammation,fibrosis, and carcinogenesis. Proc Natl Acad Sci U S A. 2010; 107:844–9. 13.Luedde T., and Schwabe RF.. NF-κB in the liver—linking injury, fibrosis and hepatocellularcarcinoma . Nat Rev Gastroenterol Hepatol, 2011; 8(2): 108–118.14. Friedman SL., 2003, Liver fibrosis from bench to bedside, J. Hepatol.; 38(81): 538-5315.Adams DH., Ju C., Ramaiah SK., Uetrecht J., and Jaeschke H., 2010. Mechanisms ofImmune-Mediated Liver Injury. Toxicol Scie; 115(2): 307–32116.Bedossa P, Poynard T, and the Metavir Cooperative Group. Intraobserver and interobservervariations in liver biopsy interpretation in patients with chronic hepatitis C. HEPATOLOGY1994;20:15-2017.Regev A., Berho M., L. J. Jeffers LJ., Milikowski C., Molina EG., Pyrsopoulos NT., et al.,Sampling error and intraobserver variation in liver biopsy in patients with chronic HCVinfection.The American Journal of Gastroenterology, 2002; 97(10): 2614–2618.18.Boursier, J., Cesbron, E., Tropet, A. L., Pilette, C. Comparison and improvement of MELDand Child-Pugh score accuracies for the prediction of 6-month mortality in cirrhotic patients. JClin Gastroenterol, 2009; 43: 580-5.19.Wynn TA.. Fibrotic Disease and The TH1/TH2 Paradigm. Immunology, 2004; 4: 583-9420.Lichtinghagen R., Bahr M. J., Wehmeier M., Michels D., Haberkorn C.I.,Arndt B., et al..Expression and coordinated regulation of matrix metalloproteinases in chronic hepatitis C andhepatitis C virus-induced liver cirrhosis, Clin Scien, 2003; 105: 373–38221.Feng Y., Cheung KF., Wang N., Liu P., Nagamatsu T., and Tong Y.. Chinese medicine as aresource for liver fibrosis treatment. Chin Med, 2009;, 4: 1-1622.Durante W, Johnson FK., and Johnson RA.. Arginase: A Critical Regulator of Nitric OxideSynthesis and Vascular Function. Clin Exp Pharmacol Physiol, 2007; 34(9): 906–911.23.Chrzanowska A., Gajewska B., and Baranczy-Kuzma A..Arginase isoenzymes in humancirrhotic liver. Acta Biochim Pol, 2009; 56(3): 465-6924.Prakash R and Mullen KD: Mechanisms, diagnosis and management of hepaticencephalopathy. Nat Rev Gastroenterol Hepatol, 2010; 7: 515-525

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