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Autotaxin predicts primary biliary cholangitis progression

01 Jun 2018

Serum concentrations of autotaxin (ATX) appear to be associated with disease progression in patients with primary biliary cholangitis (PBC), a recent study has found.

The median ATX level in PBC patients was significantly higher than that in controls (0.97 vs 0.76 mg/L; p<0.0001). This remained true even after stratification according to sex (females: 1.00 vs 0.82 mg/L; p<0.001; males: 0.78 vs 0.76 mg/L; p=0.011).

ATX was also significantly and positively correlated with disease severity. The median ATX values were 0.80, 0.87, 1.03 and 1.70 mg/L for Nakanuma’s classification stages 1, 2, 3 and 4, respectively (r=0.53; p<0.0001). The trend remained even when analysis was confined to females (r=0.54; p<0.0001) or males (r=0.71; p<0.01).

The association persisted even when disease severity was defined according to Scheuer’s classification. Median ATX levels increased from 0.89 mg/L in stage I patients to 1.19 and 1.60 mg/L in stage III and IV patients, respectively (r=0.43; p<0.0001).

Eighteen patients were determined to have Nakanuma’s liver cirrhosis stage 4, while 11 were identified with Scheuer’s stage IV. Receiver operating characteristic (ROC) curve analysis showed that ATX had good diagnostic value for liver cirrhosis in the overall sample (area under ROC [AUROC], 0.925), males (AUROC, 0.984) and females (AUROC, 0.968).

Using a two-site enzyme immunoassay, researchers measured serum ATX levels in 128 treatment-naïve PBC patients (median age 57 years), of whom 108 were female, and 80 healthy controls. Spearman’s rank test was used to determine correlations between serum ATX concentrations and disease stage.

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