Serum concentration of taurochenodeoxycholic acid predicts clinically significant portal hypertension

Abstract

Background & Aims: Severity of portal hypertension is usually quantified by measuring the hepatic venous pressure gradient (HVPG). However, due to its invasiveness, alternative markers are being sought. Bile acids (BA), being synthesized, metabolized, and transported by the liver, seem to have the potential to serve as endogenous markers. The aim of the present study was to determine whether serum BA reflect the severity of portal hypertension. Methods:We correlated serum concentrations of individual BA with portal pressure (as HVPG) in an exploratory cohort of 21 cirrhotic patients with portal hypertension.The predictive potential of selected candidates was then confirmed in an independent validation cohort (n = 214). Additionally, nine previously published noninvasive markers were added to the stepwise logistic regression model to identify the most relevant ones, which were eventually used to create a prognostic index of portal hypertension.Results: Serum levels of taurochenodeoxycholic acid (TCDCA) significantly correlated with HVPG and showed a high potential to predict clinically significant portal hypertension (HVPG ≥ 10 mm Hg: AUROC = 0.97 ± 0.06). This was confirmed in the validation cohort (AUROC = 0.96 ± 0.01). The predictive index (constructed based on AST/ ALT, spleen diameter, and TCDCA concentration) was able to distinguish clinically significant portal hypertension with 95% sensitivity and 76% specificity.Conclusions: TCDCA seems to be a promising noninvasive marker of clinically significant portal hypertension. Its predictive potential may be further enhanced when it is combined with both the AST/ALT ratio and spleen diameter.

Bile acid profiles in adult patients with biliary atresia who achieve native liver survival after portoenterostomy

“…A correlation between serum levels of GCDCA and M2BPGi, a non-invasive marker for hepatic fibrosis, was observed in patients with biliary atresia. In a recent report, serum levels of GCDCA and TCDCA were significantly correlated with portal pressure and showed a high potential to predict clinically significant portal hypertension in adults with cirrhosis 8 . In the early stages of cholestasis and cirrhosis, GCDCA was relatively higher than TCDCA 7 .…”

“…To determine why bile acid itself may be a long-term prognostic marker and its potential role in the mechanism of liver injury in biliary atresia, a comprehensive examination of bile acid compositions in long-term native liver survivors is required. The validation of bile acid profiles in adults with cirrhosis has demonstrated a strong correlation between 6-month mortality, portal hypertension and bile acid compositions, such as glycochenodeoxycholic acid (GCDCA) or taurochenodeoxycholic acid (TCDCA) 7 , 8 . In the validation of bile acid profiles in biliary atresia, it is crucial to focus on cases that meet the following criteria: (1) achieving normalized bilirubin levels to eliminate the impact of cholestasis on bile acid compositions and (2) studying cases in which physiological changes in bile acids have been completed, typically involving individuals aged 11 years and older 9 .…”

Study on the hypotensive effect and mechanism of hawthorn (Crataegus pinnatifida) fruits and hyperoside in spontaneously hypertensive rats

“…33 TCA and TCDCA participate in histamine release, affect PGE2 content, and thus participate in inflammatory responses. 34,35 DCA is also associated with the production of pro-inflammatory cytokines. 36 Previous studies have shown that UDCA can relax blood vessels, lower blood lipids, and prevent thrombosis.…”

Assessment of compensated advanced chronic liver disease based on serum bile acids in chronic hepatitis B patients

“…Thus, assessment of cACLD is an essential part of the evaluation of chronic liver disease patients in order to prognosticate, stratify therapeutic and surveillance strategies 8 . Research showed that elevated serum BA concentrations have been shown to be a more sensitive test for the detection of liver cirrhosis than conventional liver function tests 14 . Therefore, this study developed two different models (RF and SVM) based on individual BA profiles of serum samples to recognize cACLD in patients with HBV infection.…”

“…Recently, bile acid (BA), endogenous compounds that undergo efficient enterohepatic circulation, have been confirmed as an important factor in the pathophysiology of the dynamic component of portal hypertension in both animal models and in humans 14 , 15 . Therefore, the aim of our study was to develop prediction model based on individual BA profiles of serum samples to identify cACLD in patients with HBV infection.…”