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Superoxide dismutase 2 as a predictor in patients with hepatitis B virus-associated acute-on-chronic liver failure

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Abstract

The prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is critical in clinical management. We aimed to assess the prognostic efficacy of superoxide dismutase 2 (SOD2) for 90-day mortality in HBV-ACLF patients. The expression patterns of SOD2 in peripheral blood mononuclear cells (PBMCs) were examined in a derivation set (n = 82) by quantitative real-time polymerase chain reaction (RT-qPCR). The results were further validated in a validation set (n = 35). The expression levels of SOD2 were significantly decreased in the derivation set compared to those with chronic hepatitis B (CHB) or the healthy controls (HCs) (P < 0.001). In HBV-ACLF patients, SOD2 levels were negatively correlated with serum total bilirubin (TBIL) (rs = − 0.43, P < 0.001) and model for end-stage liver disease (MELD) scores (rs =  −  0.22, P = 0.047), but positively correlated with alkaline phosphatase (AKP) (rs = 0.23, P = 0.034). SOD2 was identified as an independent risk factor for 90-day mortality in HBV-ACLF patients (hazard ratio: 0.124, 95% confidence interval: 0.059–0.261, P < 0.001). SOD2 yielded a larger area under the receiver operating characteristic curve (AUROC) than the MELD score in predicting 90-day mortality (0.914 vs. 0.712, P < 0.001). Kaplan–Meier analysis revealed a favorable overall survival (OS) for the SOD2 high expression group compared with the SOD2 low expression group in both the derivation and validation sets (P < 0.001). SOD2 has promising potential as a predictor of 90-day mortality in patients with HBV-ACLF.

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Data availability

The data presented in this study are available on request from the corresponding author.

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Funding

This work was supported by the Key Project of the Chinese Ministry of Science and Technology (Grant Numbers 2017ZX10202202 and 2018ZX10302206), the National Natural Science Foundation of China (Grant Number 81970522) and the National Key Research and Development Program of China (Grant Number 2021YFC2301801).

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Authors and Affiliations

  1. Department of Hepatology, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, Shandong, China

    Huihui Liu, Haiming Li, Xuefei Wei, Linlin Li, Jinyu Zhu, Yuchen Fan & Kai Wang

  2. Department of Severe Liver Disease, Shandong Public Health Clinical Center of Shandong University, Jinan, 250000, Shandong, China

    Hui Lyu

  3. Department of Hepatology, Shandong Public Health Clinical Center of Shandong University, Jinan, 250000, Shandong, China

    Xuemei Jiang

  4. Central Laboratory, Qishan Hospital of Yantai, Yantai, 264000, Shandong, China

    Li Wang

  5. Shenzhen Research Institute of Shandong University, Shenzhen, 518000, China

    Yuchen Fan & Kai Wang

  6. Institute of Hepatology, Shandong University, Jinan, 250000, Shandong, China

    Yuchen Fan & Kai Wang

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  1. Huihui Liu
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Contributions

KW, Y-C F and H-H L contributed to the study conception and design. Material preparation, data collection and analysis were performed by H-H L, HL, X-M Jiang, LW, H-M L, X-F W, L-L L and J-Y Z. H-H L, H-M L, X-F W, L-L L and J-Y Z wrote the main manuscript text. H-H L, X-F W and L-L L prepared Figs. 1, 2, 3, 4, 5. H-M L and J-Y Z prepared Tables 1, 2, 3. All authors commented on previous versions of the manuscript. All authors reviewed the manuscript.

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Correspondence to Kai Wang.

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The authors have no conflicts of interest to disclose.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Qilu Hospital of Shandong University (Date2017-02-13).

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Liu, H., Lyu, H., Jiang, X. et al. Superoxide dismutase 2 as a predictor in patients with hepatitis B virus-associated acute-on-chronic liver failure. Clin Exp Med 23, 2181–2192 (2023). https://doi.org/10.1007/s10238-022-00979-x

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