TY - JOUR
T1 - Utility of Metabolomic Biomarkers to Identify Nonalcoholic Fatty Liver Disease in Liver Transplant Recipients
AU - Mowry, Christopher J.
AU - Alonso, Cristina
AU - Iruarrizaga-Lejarreta, Marta
AU - Ortiz, Pablo
AU - Levitsky, Josh
AU - Rinella, Mary
N1 - Funding Information:
This study was supported by grants from the Digestive Health Foundation and Northwestern Medicine Transplant Endowment.
Funding Information:
This study was supported by grants from the Digestive Health Foundation and Northwestern Medicine Transplant Endowment. We would also like to thank the Northwestern University Transplant Outcomes Research Collaborative and AST Transplantation and Immunology Research Network Summer Internship Research Program for their support. We thank One Way Liver Metabolomics for material in kind.
Publisher Copyright:
© 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
PY - 2021/11/5
Y1 - 2021/11/5
N2 - Background. Nonalcoholic fatty liver disease (NAFLD) is a rising indication for liver transplantation (LT). Identification of NAFLD recurrence and those at risk for more progressive disease after LT remains elusive as the diagnosis requires biopsy, which is invasive and impractical for serial monitoring. We therefore aimed to identify metabolites in the blood associated with recurrent NAFLD that could potentially be used for detection and monitoring. Methods. This cross-sectional pilot study included 37 LT recipients who underwent simultaneous liver biopsy and plasma collection for metabolomic analysis. Metabolic profiles were compared between patients with recurrent NAFLD, normal liver (negative control), and acute rejection (rejection control). Results. Univariate analysis revealed 14 metabolites that were significantly altered in patients with recurrence of NAFLD compared with negative controls and 19 compared with rejection controls (P<0.05). In addition, metabolomic profiling identified 16 metabolites that distinguished nonalcoholic fatty liver versus nonalcoholic steatohepatitis. Metabolite class trends among patients with recurrent NAFLD following LT were consistent with prior metabolomics data in patients with NAFLD in the non-LT setting. Conclusions. In conclusion, we identified candidate metabolites that could be used in the clinical setting to noninvasively identify recurrent NAFLD and differentiate NAFL from the more progressive nonalcoholic steatohepatitis. Further investigation with a larger sample size is warranted to validate these results.
AB - Background. Nonalcoholic fatty liver disease (NAFLD) is a rising indication for liver transplantation (LT). Identification of NAFLD recurrence and those at risk for more progressive disease after LT remains elusive as the diagnosis requires biopsy, which is invasive and impractical for serial monitoring. We therefore aimed to identify metabolites in the blood associated with recurrent NAFLD that could potentially be used for detection and monitoring. Methods. This cross-sectional pilot study included 37 LT recipients who underwent simultaneous liver biopsy and plasma collection for metabolomic analysis. Metabolic profiles were compared between patients with recurrent NAFLD, normal liver (negative control), and acute rejection (rejection control). Results. Univariate analysis revealed 14 metabolites that were significantly altered in patients with recurrence of NAFLD compared with negative controls and 19 compared with rejection controls (P<0.05). In addition, metabolomic profiling identified 16 metabolites that distinguished nonalcoholic fatty liver versus nonalcoholic steatohepatitis. Metabolite class trends among patients with recurrent NAFLD following LT were consistent with prior metabolomics data in patients with NAFLD in the non-LT setting. Conclusions. In conclusion, we identified candidate metabolites that could be used in the clinical setting to noninvasively identify recurrent NAFLD and differentiate NAFL from the more progressive nonalcoholic steatohepatitis. Further investigation with a larger sample size is warranted to validate these results.
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U2 - 10.1097/TXD.0000000000001227
DO - 10.1097/TXD.0000000000001227
M3 - Article
C2 - 34778544
AN - SCOPUS:85124223479
SN - 2373-8731
VL - 7
SP - E784
JO - Transplantation Direct
JF - Transplantation Direct
IS - 12
ER -