Angiopoietin-2 serum levels improve noninvasive fibrosis staging in chronic hepatitis C: a fibrogenic-angiogenic link
Editor
Public Library of ScienceFecha de edición
2013-06-18Cita
10.1371/journal.pone.0066143
Plos One 8.6 (2013): e66143
ISSN
1932-6203 (online)DOI
10.1371/journal.pone.0066143Financiado por
This work was partially supported by the Ministerio de Ciencia e Innovación (SAF: 2010/21805), CIBERehd (Instituto de Salud Carlos III, Madrid) and Fundación Mutua Madrileña to Ricardo Moreno-Otero and Paloma Sanz-Cameno. Paloma Sanz-Cameno has a grant from Asociación Española Contra el Cáncer (AIO 2010)Materias
antiangiogenic activity; disease association; enzyme linked immunosorbent assay; fibrogenesis; hepatitis C; MedicinaDerechos
© 2013 Hernández-Bartolomé et al.Resumen
Aims:Accurate liver fibrosis staging is crucial for the management of chronic hepatitis C (CHC). The invasiveness and cost burden of liver biopsy have driven the search for new noninvasive biomarkers of fibrosis. Based on the link between serum angiopoietin-1 and 2 levels and CHC progression, we aimed to determine the value of these angiogenic factors as noninvasive biomarkers of liver fibrosis.Methods:Serum levels of angiopoietin-1 and -2 were measured by ELISA in 108 CHC patients who underwent pretreatment liver biopsy. The correlation between angiopoietins and clinical and demographic variables with liver fibrosis was analyzed by univariate regression. Significant factors were then subjected to multivariate analysis, from which we constructed a novel noninvasive liver fibrosis index (AngioScore), whose performance was validated in an independent series of 71 CHC patients. The accuracy of this model was compared with other documented fibrosis algorithms by De Long test.Results:Angiopoietins correlated significantly with hepatic fibrosis; however, only angiopoietin-2 was retained in the final model, which also included age, platelets, AST, INR, and GGT. The model was validated and behaved considerably better than other fibrosis indices in discriminating all, significant, moderate and severe liver fibrosis (0.886, 0.920, 0.923). Using clinically relevant cutoffs, we classified CHC patients by discarding significant fibrosis and diagnosing moderate and severe fibrosis with greater accuracy, sensitivity, and specificity.Conclusions:Our novel noninvasive liver fibrosis model, based on serum angiopoietin-2 levels, outperforms other indices and should help substantially in managing CHC and monitoring long-term follow-up prognosis
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Google Scholar:Hernández-Bartolomé, Ángel
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López-Rodríguez, Rosario
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Rodríguez-Muñoz, Yolanda
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Martín-Vílchez, Samuel
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Borque, María Jesús
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García-Buey, Luisa C.
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González-Moreno, Leticia
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Real, Yolanda
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Moreno Otero, Ricardo
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Sanz-Cameno, Paloma P.
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