Li J, et al. – Authors here aimed at investigating serum Caspase–cleaved cytokeratin 18 (CK18–Asp396) levels in chronic hepatitis B (CHB). Continuous high levels of hepatocyte apoptosis as judged from serum CK 18 seemed to accompany CHB, this suggested elimination of the infected compartment constituted a defensive strategy against disease. Accordingly, CK 18 was observed as an independent predictor of significant inflammation with a high specificity.

Methods

• This study included 163 CHB patients.
• Authors determined serum CK18-Asp396 levels by enzyme-linked immunosorbent assay (ELISA), and related the results to steatosis grade, histological activity index, inflammation score, and METAVIR fibrosis grade as well as to viral load, serum levels of liver enzymes, and albumin.
• They used Receiver operating characteristic analysis to determine the diagnostic performance of serum CK18-Asp396 levels for assessing disease activity.

Results

• Patients with significant inflammation indicated a higher level of serum CK 18 concentrations in comparison to patients with no significant inflammation (378.5 [interquartile range {IQR}: 173.2–629.6] vs 137.3 [87.5–197.7], P < 0.05; approximately threefold increase) and in patients with significant fibrosis vs no significant fibrosis (177.8 [IQR: 120.8–519.1] vs 142.7 [IQR: 88.8–214.4], P < 0.05; 1.25-fold increase).
• Findings revealed no differential CK 18 level by degree of steatosis.
• Authors identified CK 18 as an independent predictor of significant inflammation with an 82% specificity and a 94% negative predictive value.
• The strongest correlation of CK 18 was observed with alanine aminotransferase and aspartate aminotransferase (both r = 0.52; P < 0.001), but it was less with albumin (r = -0.24; P < 0.05) and viral load (log) (r = 0.19; P < 0.05).