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Macrophage activation marker soluble CD 163 and non‐alcoholic fatty liver disease in morbidly obese patients undergoing bariatric surgery
Author(s) -
Kazankov Konstantin,
Tordjman Joan,
Møller Holger Jon,
Vilstrup Hendrik,
Poitou Christine,
Bedossa Pierre,
Bouillot JeanLuc,
Clement Karine,
Grønbæk Henning
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12943
Subject(s) - medicine , cd163 , fatty liver , fibrosis , immunohistochemistry , steatohepatitis , gastroenterology , weight loss , pathology , disease , macrophage , obesity , biology , biochemistry , in vitro
Background and Aims Macrophages play an important role in non‐alcoholic fatty liver disease ( NAFLD ). Soluble CD 163 (s CD 163) is a specific marker of macrophage activation. We aimed to measure s CD 163 in morbidly obese patients with varying degrees of NAFLD before and after bariatric surgery ( BS ). Methods Demographic, clinical, and biochemical data, and plasma s CD 163 measured by enzyme‐linked immunosorbent assay, of 196 patients were collected preoperatively and 3, 6, and 12 months after BS leading to significant weight loss. Peroperative liver biopsies were assessed for the NAFLD Activity Score ( NAS ), Kleiner fibrosis score, and the fatty liver inhibition of progression ( FLIP ) algorithm. In a subset, CD 163 immunohistochemistry and real‐time quantitative polymerase chain reaction for CD 163 m RNA were performed. Results s CD 163 was higher in patients with NAS ≥ 5 compared with those with NAS < 5 (2.4(2.0–3.1) vs 1.9(1.5–2.3) mg/L, P < 0.001) and in patients with bridging fibrosis (F ≥ 3) compared with lower fibrosis stages (2.6(2.0–4.9) vs 2.0(1.5–2.4) mg/L, P = 0.001). Preoperative s CD 163 was independently associated with both the NAS ( P = 0.002) and the fibrosis score ( P = 0.024). s CD 163 decreased after BS and was greatly reduced after 12 months, more rapidly so in patients with NAS ≥ 5 ( P < 0.001) and non‐alcoholic steatohepatitis ( NASH ) according to the FLIP algorithm ( P = 0.03). Immunohistochemistry showed CD 163‐positive macrophages aligning fat‐laden hepatocytes and forming microgranulomas in patients with NASH . CD 163 m RNA expression did not vary with NAS . Conclusion s CD 163 increased in parallel with the severity of NAFLD in morbid obesity, indicating macrophage activation. BS reduced s CD 163 even in patients with severe liver injury and fibrosis, suggesting full reversibility of macrophage activation associated with improved insulin sensitivity.