A novel serum marker, glycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP), for assessing liver fibrosis
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Recently, a novel marker, hyperglycosylated Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA+-M2BP), was developed for liver fibrosis using the glycan “sugar chain”-based immunoassay; however, the feasibility of WFA+-M2BP for assessing liver fibrosis has not been proven with clinical samples of hepatitis.
Serum WFA+-M2BP values were evaluated in 200 patients with chronic liver disease who underwent histological examination of liver fibrosis. The diagnostic accuracy of WFA+-M2BP values was compared with various fibrosis markers, such as ultrasound based-virtual touch tissue quantification (VTTQ), magnetic resonance imaging based-liver-to-major psoas muscle intensity ratio (LMR), and serum markers, including hyaluronic acid, type 4 collagen, and aspartate transaminase to platelet ratio index (APRI).
Serum WFA+-M2BP levels in patients with fibrosis grades F0, F1, F2, F3, and F4 had cutoff indices 1.62, 1.82, 3.02, 3.32, and 3.67, respectively, and there were significant differences between fibrosis stages F1 and F2, and between F2 and F3 (P < 0.01). The area under the receiver operating characteristic curves for the diagnosis of fibrosis (F ≥ 3) using serum WFA+-M2BP values (0.812) was almost comparable to that using VTTQ examination (0.814), but was superior to the other surrogate markers, including LMR index (0.766), APRI (0.694), hyaluronic acid (0.683), and type 4 collagen (0.625) (P < 0.01 each).
Serum WFA+-M2BP values based on a glycan-based immunoassay is an accurate, reliable, and reproducible method for the assessment of liver fibrosis. This approach could be clinically feasible for evaluation of beneficial therapy through the quantification of liver fibrosis in hepatitis patients if this measurement application is commercially realized.
KeywordsLiver fibrosis Chronic hepatitis M2BP Mac-2 binding protein VTTQ Fibrosis marker
Aspartate transaminase-to-platelet ratio index
Acoustic radiation force impulse
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid
Hepatitis B virus surface antigen
Hepatitis B virus
Hepatitis C virus
Hepatitis C virus antibody
Liver-to-major psoas muscle intensity ratio
Meters per second
Magnetic resonance imaging
Negative predictive value
Negative for hepatitis B virus surface antigen and hepatitis C virus antibody
Primary biliary cirrhosis
Positive predictive value
Receiver operating characteristic
Virtual Touch™ Tissue Quantification
Wisteria floribunda agglutinin-positive Mac-2 binding protein
This study was supported by a Grant-in-Aid from the Ministry of Health, Labour and Welfare, Japan (H23-kannen-011). This research was performed by the Hepatitis Glyco-biomarker Study Group.
Conflict of interest
The authors declare that they have no conflict of interest and have no financial interests linked to this work.
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