Elisa Pose Mendez
UNIVERSITAT DE BARCELONA
I am Phd student at the Liver Unit of Hospital Clinic de Barcelona, where I have completed my residency period in Digestive Diseases last year. Currently I am developing my PhD project in liver immunology and macrophages function in decompensated cirrhosis and Acute-On-Chronic Liver Failure.
Adipocyte fatty-acid binding protein (A-FABP4) is a small intracellular protein that coordinates lipid-mediated processes by targeting metabolic and immune response pathways in adipocytes and macrophages. A-FABP4 plasma levels have been associated with liver inflammation in chronic liver disease
AIM: To investigate hepatic gene expression and plasma levels of A-FABP4 and their relationship with clinical outcomes in cirrhosis.
METHODS: Hepatic A-FABP4 expression was assessed by RT-PCR in whole liver and in distinct hepatic cells subpopulations, including hepatocytes, hepatic stellate cells, macrophages, lymphocytes, and neutrophils in experimental model of chronic liver disease. Hepatic A-FABP4 expression was assessed in biopsies of patients with decompensated cirrhosis (n=22) by RT-PCR and immunohistochemistry. Finally, plasma levels of A-FABP4 were measured in 274 patients with decompensated cirrhosis.
RESULTS: Hepatic A-FABP4 expression was up-regulated in the liver of the experimental model of chronic liver disease and among all cell populations explored, macrophages were the only hepatic cells that significantly overexpressed A-FABP4. Hepatic A-FABP4 expression was up-regulated in liver biopsies from patients with decompensated cirrhosis and macrophages showed positive staining for A-FABP4. Plasma levels
(A-FABP4: 37 (20-68) vs 16 (11-33)ng/mL p=0.002). of A-FABP4 were increased in patients with decompensated cirrhosis compared to healthy subjects. Increased A-FABP4 levels were associated with complications of cirrhosis, acute-on-chronic liver failure and poor survival.
CONCLUSIONS: Hepatic A-FABP4 expression is up-regulated in cirrhosis and liver macrophages appear to be the main source of A-FABP4. Plasma levels of A-FABP4 are increased in decompensated cirrhosis and correlate with poor outcomes.
