A new study published in Scientific Reports has identified Galectin-9 (Gal-9) as a promising biomarker for hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). The research highlights the potential of Gal-9 in improving the diagnosis, prognosis, and risk stratification of patients with this severe liver disease.
The study compared plasma Gal-9 levels in patients with HBV-ACLF and those with chronic hepatitis B (CHB). Results showed significantly higher Gal-9 levels in the HBV-ACLF group (p < 0.00022). Furthermore, the expression of Gal-9 was found to be elevated in CD4+ and CD8+ T cells of HBV-ACLF patients.
Gal-9 Expression and Clinical Indicators
Spearman correlation analysis revealed that plasma Gal-9 levels were positively correlated with several clinical indicators of liver failure, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL) (p < 0.05). Notably, Gal-9 showed the strongest positive correlation with AST (coefficient of 0.77) and TBIL (coefficient of 0.66), and a strong negative correlation with lactic acid (LA, coefficient of -0.94).
Prognostic Significance of Gal-9
The study also assessed the prognostic value of Gal-9 in patients with HBV-ACLF. Kaplan-Meier survival analysis demonstrated a significant association between Gal-9 expression levels and overall survival (p = 0.022). Patients were stratified based on an optimal Gal-9 threshold value of 9.6 ng/ml, determined by receiver operating characteristic (ROC) curve analysis.
Gal-9 and MELD Score
To evaluate the predictive ability of Gal-9, researchers compared it to the Model for End-Stage Liver Disease (MELD) score, a commonly used assessment tool for liver failure. The area under the curve (AUC) for Gal-9 was 0.79 (95% CI 0.6251–0.9683; p = 0.0174), while the AUC for MELD was 0.76 (95% CI 0.5992–0.9338; p = 0.0327). Combining Gal-9 with the MELD score significantly improved the prediction of patient outcomes, with a joint AUC of 0.945 (95% CI 0.863–1.000; p < 0.05).
Implications for Clinical Practice
These findings suggest that Gal-9 could serve as a valuable biomarker for identifying and managing patients with HBV-ACLF. Its ability to predict prognosis, especially when combined with the MELD score, may help clinicians to better stratify patients and make more informed treatment decisions. Further research is needed to validate these findings in larger cohorts and to explore the potential of Gal-9 as a therapeutic target.
