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Single‐centre experience of the macrophage activation marker soluble (s)CD163 – associations with disease activity and treatment response in patients with autoimmune hepatitis
Author(s) -
Grønbæk H.,
Kreutzfeldt M.,
Kazankov K.,
Jessen N.,
Sandahl T.,
HamiltonDutoit S.,
Vilstrup H.,
J. Møller H.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13801
Subject(s) - medicine , autoimmune hepatitis , gastroenterology , cd163 , prednisolone , inflammation , hepatitis , immunology , macrophage , biochemistry , chemistry , in vitro
Summary Background Autoimmune hepatitis ( AIH ) is characterised by liver inflammation with reversibility upon anti‐inflammatory treatment. Soluble (s) CD 163, a specific macrophage activation marker, is associated with inflammation in other liver diseases, but never investigated in AIH . Aim To investigate sCD 163 in patients with acute AIH and in complete and incomplete responders to standard anti‐inflammatory pharmacotherapy, and during follow‐up in treatment naive patients. Methods In a cross‐sectional design, we studied 121 AIH patients (female/male 89/32, median age 49 years); of these, we prospectively studied 10 treatment naïve AIH patients during prednisolone treatment and tapering. Twenty patients had variant syndromes of AIH and primary biliary cholangitis or primary sclerosing cholangitis. sCD 163 was compared with markers of disease activity, severity and treatment response. Results In the patients with acute AIH ( n = 21), sCD 163 was sixfold increased compared with the normalised levels in patients ( n = 32) with complete response to standard treatment [9.5 (3.3–28.8) vs. 1.6 (0.8–3.2) mg/L, P < 0.01)], while the patients ( n = 27) with incomplete response had higher sCD 163 [2.2 (1.3–7.9), P < 0.05] than the complete responders. sCD 163 was positively associated with ALAT , IgG and bilirubin (rho: 0.45–0.59, P < 0.001, all), and negatively to external coagulation factors (rho:−0.34, P < 0.001). In the treatment naïve patients, sCD 163 fell during high‐dose prednisolone treatment and tapering. Immunohistochemical staining confirmed increased CD 163 expression in liver biopsies from patients with acute AIH. Conclusions sCD 163 was markedly elevated in AIH in the acute phase, normalised by successful treatment in complete responders, but remained higher in the incompletely responding cases. Our results demonstrate macrophage activation in AIH paralleling disease activity, severity and treatment response, suggesting a role for macrophage activation in AIH .