Js. Johansen et al., PLASMA YKL-40 - A NEW POTENTIAL MARKER OF FIBROSIS IN PATIENTS WITH ALCOHOLIC CIRRHOSIS, Scandinavian journal of gastroenterology, 32(6), 1997, pp. 582-590
Background: YKL-40 (human cartilage glycoprotein-39, or 38-kDa heparin
-binding glycoprotein) is a mammalian member of a protein family that
includes bacterial chitinases. YKL-40 mRNA is expressed by human liver
and may play a role in tissue remodelling. The aims were to assess wh
ether circulating YKL-40 is released or extracted in the hepatosplanch
nic system and to localize YKL-40 in liver tissue. Methods: Plasma YKL
-40 was determined by radioimmunoassay in 25 patients with liver disea
ses (alcoholic cirrhosis (n = 20), chronic active hepatitis (n = 2), c
irrhosis of unknown aetiology (n = 2), and fatty liver (n = 1)) and in
18 subjects with normal liver function during a haemodynamic investig
ation with catheterization of liver vein and the femoral artery. Immun
ohistochemical studies of the localization of YKL-40 in cryostat liver
biopsy specimens were obtained from eight other patients with alcohol
ic liver disease. Results: Plasma YKL-40 was significantly increased i
n patients with alcoholic cirrhosis (median, 523 mu g/l; P < 0.001) co
mpared with controls (106 mu g/l), and plasma YKL-40 in the hepatic ve
in was higher (P < 0.01) than that of the artery in both the patients
and controls, showing release of YKL-40 from the hepatosplanchnic area
. The release rate of YKL-40 from the hepatosplanchnic area was higher
in patients with liver disease than in controls (11.0 versus 2.1 mu g
/min, P < 0.05). Furthermore, the highest plasma YKL-40 levels were fo
und in patients with a moderate or severe degree of liver fibrosis, an
d immunohistochemical studies showed positive staining for YKL-40 anti
gen in areas of the liver biopsy with fibrosis. Conclusions: The incre
ased plasma YKL-40 in patients with alcoholic cirrhosis may reflect th
e remodelling of liver fibrosis.