Serum macrophage inflammatory protein 3α levels predict the severity of HBV-related acute-on-chronic liver failure

Dear Editor, We read with interest the paper by Angeli et al 1 proposing the value of the acute-on-chronic liver failure (ACLF) stratification in the prediction of short-term mortality in patients with acute decompensation of cirrhosis. Other studies2 ,3 indicated that the dynamic changes in serological markers are associated with patients who have cirrhosis. We hypothesised that the pathological processes of HBV-related ACLF (HBV-ACLF) would result in specific changes in the levels of signalling proteins in the blood. Thus, we aimed to search detectable biomarkers to predict the outcome of HBV-ACLF. We collected serum samples from 420 patients with HBV-ACLF, 121 patients with chronic hepatitis B (CHB) and 25 normal controls to identify novel serological biomarkers of HBV-ACLF (see online supplementary table S1). As an initial screening group, 15 subjects were included in the cytokine antibody array analyses (n=5 per group). The remaining 551 subjects were included in the ELISA measurement group. The enrolment criteria for the patients with HBV-ACLF corresponded to the previously published the chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score.4 The bioinformatics analyses of …