Elevated serum HE4 levels as a novel biomarker of disease severity and hepatic fibrosis in autoimmune hepatitis

• Published in: Clinica chimica acta 2024-06, Vol.559, p.119682-119682, Article 119682
• Main Authors: Yu, Zhi, Nian, Caina, Sun, Wenmei, Liu, Xinhua, Nian, Xueyuan
• Format: Article
• Language: English
• Subjects: Autoimmune hepatitis; Cirrhosis; Hepatic fibrosis; Human epididymis protein 4
• ISSN: 0009-8981; 1873-3492
• DOI: 10.1016/j.cca.2024.119682

•This is the first study to examine the association between serum HE4 and disease severity and hepatic fibrosis in AIH.•Serum HE4 levels were found to be elevated in AIH-LC patients.•Serum HE4 was strongly correlated with the severity of hepatic fibrosis and cirrhosis of AIH.•High levels of serum HE4 (≥82.34 pmol/L) were associated with poor outcome.•serum HE4 levels might be a novel biomarker of disease severity and hepatic fibrosis in AIH. Human epididymis protein 4 (HE4) has been identified as a biomarker for renal fibrosis. This study aimed to evaluate the role of HE4 in the diagnosis and determination of disease severity and hepatic fibrosis in autoimmune hepatitis (AIH). Serum HE4 levels were determined via electrochemiluminescence immunoassays in 60 healthy controls and 109 AIH patients (43 without liver cirrhosis and 66 with liver cirrhosis). Liver biopsy was performed on 56 of 109 enrolled patients. We conducted a 5-year follow-up survey of 53 enrolled patients. All continuous variables were reported as median (25th–75th percentile). Serum HE4 levels were significantly elevated in autoimmune hepatitis with liver cirrhosis (AIH-LC) patients compared with AIH patients and healthy controls [98.60 (74.15–139.08) vs 73.50 (59.88–82.00) vs 48.75 (43.38–52.93) pmol/L, p = 0.004]. The serum HE4 levels showed a positive correlation with the METAVIR scoring system in patients with liver biopsy (r = 0.711, p