Evaluation of Amino Acids Profile as Non-Invasive Biomarkers of Hepatocellular Carcinoma in Egyptians

Samar Ebrahim Ghanem; Mohamed Abdel-Samiee; Hala El-Said; Mohamed I Youssef; Hassan Ahmed ElZohry; Eman Abdelsameea; Inas Moaz; Sayed F Abdelwahab; Shymaa A Elaskary; Eman Mohammed Zaher; Marwa Lotfy Helal

doi:10.3390/tropicalmed7120437

Evaluation of Amino Acids Profile as Non-Invasive Biomarkers of Hepatocellular Carcinoma in Egyptians

Trop Med Infect Dis. 2022 Dec 13;7(12):437. doi: 10.3390/tropicalmed7120437.

Affiliations

¹ Department of Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt.
² Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt.
³ Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt.
⁴ Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt.
⁵ Department of Pharmaceutics and Industrial Pharmacy, Taif College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
⁶ Department of Medical Microbiology and Immunology, Faculty of Medicine, Menoufia University, Shebin El-Kom 32511, Egypt.
⁷ Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebin El-Kom 32511, Egypt.

Abstract

Background: Hepatocellular carcinoma (HCC) is the most dangerous complication of chronic liver disease. It is a multifactorial complicated disease. Hepatitis C and hepatitis B viruses (HCV and HBV, respectively) represent the main causes of HCC in Egypt. Early diagnosis is very important to aid in early intervention.

Objectives: The goal of this research is to evaluate the metabolic role of different amino acids as non-invasive biomarkers over the course of HCC.

Methods: This study included 302 participants with 97 diagnosed, untreated HCC patients, 81 chronic HCV patients, 56 chronic HBV patients, 18 co-infected patients, and a control group of 50 normal age and gender-matched individuals. All participants provided complete medical histories and underwent complete clinical examinations, abdominal ultrasonography and/or computed tomography, routine laboratory investigations, estimation of serum α-fetoprotein, and determination of amino acid levels using ultra-performance liquid chromatography (UPLC MS/MS).

Results: This work revealed a decline in branched chain amino acids (BCAA) and increase in aromatic amino acids (AAA) among infected groups (HCC, HBV, HCV, and co-infected patients) compared to control subjects and a marked change in Fisher's and the BCAAs/tyrosine molar concentration ratios (BTR) between controls and infected groups.

Conclusion: Different amino acids could be used as non-invasive markers to discriminate and follow chronic hepatitis patients to predict the course of HCC.

Keywords: BTR; Fischer’s ratio; aromatic amino acids; branched chain amino acids; triple quadrupoletandem mass spectrometry; ultra-performance liquid chromatography.

Grants and funding

This study was partially funded by the Menoufia University project titled “Metabolomics characterization of chronic liver diseases versus Hepatocellular carcinoma in Egyptian patients using Chromatography Mass Spectrometry for early diagnosis of HepatocellularCarcinoma”.