Association Between The Expression Level Of MANF Protein And Liver Fibrosis Progression After Chronic Hepatitis B Virus Infection

Objectives To investigate the difference of endoplasmic reticulum stress related MANF protein expression level and its non-invasive diagnosis value for liver fibrosis in chronic HBV infection patients.Methods The severity of liver fibrosis in169 chronic hepatitis B virus infection patients was assessed by liver biopsy,the routine laboratory indicators were examined to calculate APRI and FIB-4 index.The expression level of MANF protein in peripheral blood plasma was measured by ELISA method.The diagnostic value of MANF protein,APRI and FIB-4 index insignificant fibrosis and advanced fibrosis were assessed according to the area under the receiver operating characteristic curves(ROC),the sensitivity(SN)and specificity(SP).Results1.The expression level of MANF protein between the health control(HC)group,S0-1 group,S2 group and S3-4 group patients had statistically significant difference(F=17.55,P<0.05).Further analysis showed that the expression levels of MANF protein had statistically significant difference in the pairwise comparison of the HC group,S0-1 group,S2 group and S3-4 group patients,P<0.05,beside S0-1 group and S2 group.With the severity of liver fibrosis,the significant correlation was found between the expression level of MANF protein and liver fibrosis,rs=0.431,P<0.001,the correlation was similar with APRI and FIB-4 indexes.2.The expression level of MANF protein in different levels of ALT(< 80 U/L,80-250 U/L and > 250U/L)was statistically difference(F=5.955,P =0.003),MANF protein in different levels of AST(< 80U/L,80-250U/L and >250 U/m L)was statistically difference(F=4.908,P=0.009),but there was no statistical difference between patients with different levels of HBs Ag,HBV DNA,and between HBe Ag positive group and negative group.Conclusion The expression level of MANF protein gradually increase with the fibrosis progression after chronic HBV infection,it could have a better predictive value for the degree of liver fibrosis.