Acute-on-chronic hepatitis B liver failure (ACHBLF) is one severe liver disease with rapid progression and high mortality. Identification of specific markers for the prediction of ACHBLF has important clinical significance. We explored the feasibility of UBE2Q1 gene promoter methylation as an early prediction and prognosis biomarker of ACHBLF.UBE2Q1 promoter methylation frequency was detected in 60 patients with acute-on-chronic hepatitis B pre-liver failure (Pre-ACHBLF), 40 patients with chronic hepatitis B and 20 cases of healthy control (HC). The UBE2Q1 mRNA was detected by quantitative real-time polymerase chain reaction.The methylation frequency of the UBE2Q1 promoter in pre-ACHBLF patients was 38.33%, which was significantly lower than that in chronic hepatitis B patients (60.00%) and HCs (65.00%). The UBE2Q1 mRNA expression in pre-ACHBLF patients with UBE1Q1 non-methylation was significantly higher than that in patients with UBE1Q1 promoter methylation. Further analysis showed that hypomethylation of the UBE2Q1 promoter was positively correlated with total bilirubin and international normalized ratio levels in patients with pre-ACHBLF, but negatively correlated with PTA level. COX multivariate analysis showed that the model for end-stage liver disease score and UBE2Q1 promoter hypomethylation status were potential early warning factors that can predict the progression of pre-ACHBLF to ACHBLF. The sensitivity and specificity of UBE2Q1 promoter methylation status combined with the model for end-stage liver disease score for early diagnosis of ACHBLF were 92.9% and 75.0%, respectively. The area under the receiver-operating characteristic curve was 0.895.The hypomethylation of UBE2Q1 promoter is associated with severity of Pre-ACHBLF, which could serve as a potential prognostic biomarker for pre-ACHBLF.Abbreviations: ACHBLF = acute-on-chronic hepatitis B liver failure, ACLF = acute-on-chronic liver failure, AFP = alpha fetoprotein, ALB = albumin, ALT = alanine aminotransferase, AST = aspartate aminotransferase, AUC = area under the ROC curve, CHB = chronic hepatitis B, GSTP1 = glutathione-S-transferase P1, HBeAg = Hepatitis B e antigen, HBsAg = hepatitis B surface antigen, HC = healthy control, INR =international normalized ratio, MELD = model for end-stage liver disease, PBMCs = peripheral blood mononuclear cells, Pre-ACHBLF = acute-on-chronic hepatitis B pre-liver failure, pre-ACLF = acute-on-chronic pre-liver failure, PTA = prothrombin time activity, ROC curves = receiver-operating characteristic curves, TBIL = total bilirubin.
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