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Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery

Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established a...

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Autores principales: Hempel, Felix, Roderfeld, Martin, Müntnich, Lucas John, Albrecht, Jens, Oruc, Ziya, Arneth, Borros, Karrasch, Thomas, Pons-Kühnemann, Jörn, Padberg, Winfried, Renz, Harald, Schäffler, Andreas, Roeb, Elke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002276/
https://www.ncbi.nlm.nih.gov/pubmed/33809676
http://dx.doi.org/10.3390/jcm10061233
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author Hempel, Felix
Roderfeld, Martin
Müntnich, Lucas John
Albrecht, Jens
Oruc, Ziya
Arneth, Borros
Karrasch, Thomas
Pons-Kühnemann, Jörn
Padberg, Winfried
Renz, Harald
Schäffler, Andreas
Roeb, Elke
author_facet Hempel, Felix
Roderfeld, Martin
Müntnich, Lucas John
Albrecht, Jens
Oruc, Ziya
Arneth, Borros
Karrasch, Thomas
Pons-Kühnemann, Jörn
Padberg, Winfried
Renz, Harald
Schäffler, Andreas
Roeb, Elke
author_sort Hempel, Felix
collection PubMed
description Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established as a marker of hepatocyte apoptosis, a key event in NASH development. Thus, ccK18 measurements might be feasible to monitor bariatric surgery patients. Clinical data and laboratory parameters were collected from 39 patients undergoing laparoscopic Roux-en-Y gastric bypass at six timepoints, prior to surgery until one year after the procedure. ccK18 levels were measured and a high-throughput analysis of serum adipokines and cytokines was carried out. Half of the cohort’s patients (20/39) presented with ccK18 levels indicative of progressed liver disease. 21% had a NAFLD-fibrosis score greater than 0.676, suggesting significant fibrosis. One year after surgery, a mean weight loss of 36.87% was achieved. Six and twelve months after surgery, ccK18 fragments were significantly reduced compared to preoperative levels (p < 0.001). Yet nine patients did not show a decline in ccK18 levels ≥ 10% within one year postoperatively, which was considered a response to treatment. While no significant differences in laboratory parameters or ccK18 could be observed, they presented with a greater expression of leptin and fibrinogen before surgery. Consecutive ccK18 measurements monitored the resolution of NAFLD and identified non-responders to bariatric surgery with ongoing liver injury. Further studies are needed to elicit the pathological mechanisms in non-responders and study the potential of adipokines as prognostic markers.
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spelling pubmed-80022762021-03-28 Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery Hempel, Felix Roderfeld, Martin Müntnich, Lucas John Albrecht, Jens Oruc, Ziya Arneth, Borros Karrasch, Thomas Pons-Kühnemann, Jörn Padberg, Winfried Renz, Harald Schäffler, Andreas Roeb, Elke J Clin Med Article Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established as a marker of hepatocyte apoptosis, a key event in NASH development. Thus, ccK18 measurements might be feasible to monitor bariatric surgery patients. Clinical data and laboratory parameters were collected from 39 patients undergoing laparoscopic Roux-en-Y gastric bypass at six timepoints, prior to surgery until one year after the procedure. ccK18 levels were measured and a high-throughput analysis of serum adipokines and cytokines was carried out. Half of the cohort’s patients (20/39) presented with ccK18 levels indicative of progressed liver disease. 21% had a NAFLD-fibrosis score greater than 0.676, suggesting significant fibrosis. One year after surgery, a mean weight loss of 36.87% was achieved. Six and twelve months after surgery, ccK18 fragments were significantly reduced compared to preoperative levels (p < 0.001). Yet nine patients did not show a decline in ccK18 levels ≥ 10% within one year postoperatively, which was considered a response to treatment. While no significant differences in laboratory parameters or ccK18 could be observed, they presented with a greater expression of leptin and fibrinogen before surgery. Consecutive ccK18 measurements monitored the resolution of NAFLD and identified non-responders to bariatric surgery with ongoing liver injury. Further studies are needed to elicit the pathological mechanisms in non-responders and study the potential of adipokines as prognostic markers. MDPI 2021-03-16 /pmc/articles/PMC8002276/ /pubmed/33809676 http://dx.doi.org/10.3390/jcm10061233 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hempel, Felix
Roderfeld, Martin
Müntnich, Lucas John
Albrecht, Jens
Oruc, Ziya
Arneth, Borros
Karrasch, Thomas
Pons-Kühnemann, Jörn
Padberg, Winfried
Renz, Harald
Schäffler, Andreas
Roeb, Elke
Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title_full Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title_fullStr Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title_full_unstemmed Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title_short Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery
title_sort caspase-cleaved keratin 18 measurements identified ongoing liver injury after bariatric surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002276/
https://www.ncbi.nlm.nih.gov/pubmed/33809676
http://dx.doi.org/10.3390/jcm10061233
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