Monomeric C-reactive protein is associated with severity and prognosis of decompensated hepatitis B cirrhosis

Front Immunol. 2024 Jun 4:15:1407768. doi: 10.3389/fimmu.2024.1407768. eCollection 2024.

Abstract

C-reactive protein (CRP) is an acute-phase protein produced by the liver in response to infection and during chronic inflammatory disorders. Systemic inflammation is a major driver of cirrhosis progression from the compensated to the decompensated stage. Previous studies have shown that pentameric CRP (pCRP) to be a weak predictor of disease severity and prognosis in patients with decompensated hepatitis B cirrhosis, with it being only helpful for identifying patients with a higher short-term risk of death under certain conditions. Accumulating evidence indicates that pCRP dissociates to and acts primarily as the monomeric conformation (mCRP) at inflammatory loci, suggesting that mCRP may be a potentially superior disease marker with higher specificity and relevance to pathogenesis. However, it is unknown whether mCRP and anti-mCRP autoantibodies are associated with disease severity, or progression in decompensated hepatitis B cirrhosis. In this study, we evaluated the serum levels of mCRP and anti-mCRP autoantibodies in patients with decompensated cirrhosis of hepatitis B and their association with disease severity and theoretical prognosis. The results showed that patients with high mCRP and anti-mCRP autoantibody levels had more severe liver damage and that coagulation function was worse in patients with high anti-mCRP autoantibodies. Analysis of the correlation between pCRP, mCRP and anti-mCRP autoantibody levels with Model for End-Stage Liver Disease (MELD), Albumin-Bilirubin (ALBI), and Child-Turcotte-Pugh (CTP) prognostic scores showed that mCRP was the most strongly correlated with MELD score, followed by anti-mCRP autoantibodies; conversely, pCRP was not significantly correlated with prognostic score. Therefore, mCRP and anti-mCRP autoantibodies may be more advantageous clinical indicators than pCRP for evaluating the pathological state of decompensated hepatitis B cirrhosis.

Keywords: C-reactive protein; autoantibodies; decompensated hepatitis B cirrhosis; inflammation; monomeric C-reactive protein.

MeSH terms

  • Adult
  • Autoantibodies* / blood
  • Autoantibodies* / immunology
  • Biomarkers* / blood
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Disease Progression
  • Female
  • Hepatitis B / blood
  • Hepatitis B / immunology
  • Humans
  • Liver Cirrhosis* / blood
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / etiology
  • Liver Cirrhosis* / immunology
  • Male
  • Middle Aged
  • Prognosis
  • Severity of Illness Index*

Substances

  • C-Reactive Protein
  • Autoantibodies
  • Biomarkers

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (82270736,32160180); the Natural Science Foundation of ShannXi, China (2023-ZDLSF-10), and the Xi’an Jiaotong University Medical Basics-Clinical Integration Innovation Project.