Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Tuesday, 06 / 15 / 2021



Autotaxin: An Early Warning Biomarker for Acute-on-chronic Liver Failure

Caiyun Nie1,2 , Lei Zhang3 Xiaobing Chen1,2 Ying Li4,5,6,7,8,9, Fushuang Ha5,6,7,8,9 , Hua Liu4,5,6,7,8,9 and Tao Han4,5,6,7,8,9

1  Department of Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China
2  Henan Cancer Hospital, Zhengzhou, Henan, China
3  Department of Clinical Laboratory, Tianjin Third Central Hospital, Tianjin, China
4  The Third Central Clinical College of Tianjin Medical University, Tianjin, China
5  The Affiliated Hospital of Nankai University, Tianjin, China
6  Department of Hepatology and Gastroenterology, Tianjin Third Central Hospital, Tianjin, China
7  Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, China
8  Artificial Cell Engineering Technology Research Center, Tianjin, China
9  Tianjin Institute of Hepatobiliary Disease, Tianjin, China
*Correspondence to: Tao Han, Department of Hepatology and Gastroenterology, Tianjin Institute of Hepatobiliary Disease, Tianjin Key Laboratory of Artificial Cells, Tianjin Third Central Hospital, 83 Jintang Road, Tianjin 300170, China. Tel: +86-22-84112298, Fax: +86-22-84112208, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2020;8(3):240-245 DOI: 10.14218/JCTH.2020.00045
Received: May 12, 2020 Accepted: June 30, 2020 Published online: July 21, 2020


Background and Aims: Recent accumulating evidence indicates the biological actions of autotaxin (ATX) in liver disease. However, the relationship between ATX and liver failure has not been reported. The present study aimed to examine alterations of serum ATX in acute-on-chronic liver failure (ACLF) and evaluate whether serum ATX could be useful as an early warning biomarker of ACLF.

Methods: Serum ATX was measured in 50 patients with hepatitis B-related ACLF, 14 patients with alcohol-related ACLF, 11 patients with hepatitis B-related pre-ACLF, 11 patients with alcohol-related Child-Pugh A cirrhosis, 39 patients with hepatitis B-related Child-Pugh A cirrhosis, 26 patients with chronic hepatitis B, and 38 healthy volunteers by enzyme-linked immunosorbent assay.

Results: Serum ATX level was significantly higher in the pre-ACLF group than in the Child-Pugh A cirrhosis and chronic hepatitis B groups but lower than in the ACLF group; furthermore, patients with pre-ACLF deteriorated to ACLF had significantly higher serum ATX levels than pre-ACLF patients that did not progress to ACLF. Serum ATX levels were significantly higher among male ACLF patients with preclinical infection, spontaneous bacterial peritonitis or pneumonia, as compared to patients with ACLF but no spontaneous bacterial peritonitis or pneumonia. Serum ATX levels were well correlated with serum biochemical parameters of liver function and model for end-stage liver disease score. Serum ATX ≥ 584.1 ng/mL was a poor prognostic factor for ACLF (hazard ratio of 4.750, 95% confidence interval of 1.106-20.392, p=0.036).

Conclusions: Serum ATX level may be a useful early warning biomarker for ACLF.


Autotaxin, ATX, Liver failure, Serum, Biomarker

Journal of Clinical and Translational Hepatology 2020 vol. 8, 240-245  [ Html  ] [ PDF Full-text ]

© The Authors 2020. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.


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