Dysregulated iron homeostasis is strongly associated with multiorgan failure and early mortality in acute-on-chronic liver failure

Jaswinder Singh Maras, Rakhi Maiwall, H. C. Harsha, Sukanta Das, Md Shabir Hussain, Chandan Kumar, Chhagan Bihari, Archana Rastogi, Manoj Kumar, Nirupama Trehanpati, Shvetank Sharma, Akhilesh Pandey, Shiv Kumar Sarin

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Acute-on-chronic liver failure (ACLF) is an ailment with high incidence of multiorgan failure (MOF) and consequent mortality. Dysregulated iron homeostasis and macrophage dysfunction are linked to increased incidence of MOF. We investigated whether a panel of circulating iron-regulating proteins are associated with development of MOF and can predict 15- or 30-day mortality in ACLF patients. One hundred twenty patients with ACLF, 20 patients with compensated cirrhosis, and 20 healthy controls were studied. Relative protein expression profiling was performed in the derivative cohort and confirmed in the validation cohort. A panel of iron regulators and indices were determined. Multiparametric flow cytometry for quantitation of labile iron pool (LIP) was performed. Validation studies confirmed lower serum transferrin (Tf) and ceruloplasmin levels in ACLF and ACLF-MOF, compared to patients with cirrhosis and controls (P

Original languageEnglish (US)
Pages (from-to)1306-1320
Number of pages15
JournalHepatology
Volume61
Issue number4
DOIs
StatePublished - Apr 1 2015

ASJC Scopus subject areas

  • Hepatology
  • General Medicine

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