Association Between Expression Level Of Mesencephalic Astrocytederived Neurotrophic Factor Protein And Disease Progression In Patients With Chronic Hepatitis B Virus Infection

Objective To investigate the expression level of endoplasmic reticulum stress related mesencephalic astrocyte-derived neurotrophic factor(MANF) protein and assess its clinical significance in patients with chronic hepatitis B virus(HBV) infection.Methods The expression levels of MANF protein in peripheral blood plasma was measured by ELISA in asymptomatic hepatitis B virus surface antigen(HBs Ag) carriers(ASC),chronic hepatitis B(CHB), compensatory liver cirrhosis(CLC) and decompensated liver cirrhosis(DLC) patients after chronic HBV infection and normal healthy controls(HC). The relationship between MANF protein expression and different stages of chronic HBV infection was analyzed. To all patients with HBs Ag, hepatitis B e antigen(HBe Ag) quantitative, HBV-DNA levels, alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL) level according to certain standard classification, MANF expression differences between different categories in each group was analyzed.Results1. The expression levels of MANF protein among the HC, ASC, CHB, CLC, and DLC groups had a statistically significant difference(F=7.391, P=0.00). Further dataanalysis showed that the expression levels of MANF protein in the CLC and DLC groups had a statistically significant difference compared with the HC, ASC and CHB groups, but there was no significant difference between the HC, ASC and CHB groups.2. The expression levels of MANF protein had a statistically significant difference in the three groups of patients stratified by HBs Ag level(<1000 IU/m L, 1000-20000IU/m L and >20000 IU/m L)(F=9.420, P<0.001). The difference in MANF protein expression levels was statistically significant between patients with different levels of AST(<80u/m L, 80-250 u/m L and >250 u/m L)(F=3.188, P=0.045) and TBIL(t= 2.867,P=0.005), but there was no statistical difference between patients with different levels of ALT, HBV DNA, or between HBe Ag positive group and HBe Ag-negative group.Conclusion Patients with chronic HBV infection, different stages of disease of peripheral blood MANF protein expression level exists significant difference, especially in patients with LC, MANF protein levels significantly decreased. The expression levels of MANF protein are negatively associated with the disease progression in patients with chronic HBV infection.