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Changes in Circulating Lysyl Oxidase-Like-2 (LOXL2) Levels, HOMA, and Fibrosis after Sustained Virological Response by Direct Antiviral Therapy

1
Digestive Disease Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
2
Health Research Institute Marques de Valdecilla, IDIVAL, 39011 Santander, Spain
3
Medicine and Psychiatry Department, Cantabria University, 39011 Santander, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1242; https://doi.org/10.3390/jcm8081242
Received: 1 July 2019 / Revised: 9 August 2019 / Accepted: 13 August 2019 / Published: 17 August 2019
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Background: we aimed to assess the influence of metabolic syndrome on fibrosis regression (using liver-stiffness measurement (LSM) and serological scores) and the relationship with the expression of lysyl oxidase-like-2 as a potential goal of antifibrotic therapy. Methods: We included 271 patients treated with Direct Antiviral Therapy (DAAs) in our hospital who achieved a sustained virological response (SVR); physical examination, blood tests, and LSM were made at baseline (B) and 24 months (24 M) after SVR. Hemodynamic studies and transjugular liver biopsies were performed on 13 patients. Results: At B, 68 patients were F1 (25.1%); F2 n = 59 (21.7%); F3 n = 44 (16.05%); and 100 were F4 (36.9%). Although the LSM (absolute value) improved in 82% of patients (n = 222), it progressed in 17.5% of patients (n = 48). At 24 M, 48 patients met the metabolic syndrome (MetS) criteria and there was an increase in patients with a BMI of >25 kg/m2 (p < 0.001). At B and 24 M, a BMI of >25 kg/m2 is a risk factor for significant fibrosis or steatosis at 24 M (p < 0.05) and progression on LSM (p < 0.001), as well as MetS at B and 24 M (OR 4.1 IC (1.4–11.7), p = 0.008; and OR 5.4 IC (1.9–15.4), p = 0.001, respectively). Regarding the correlation between LSM and the liver biopsy, we found that only six out of 13 patients had a matching LSM and biopsy. We found a statistically significant decrease in LOXL2 levels at 24 M with respect to B (p < 0.001) with higher serological value in patients with elastography of >9 kPa vs. <9 kPa (p = 0.046). Conclusion: Regression of LSM was reached in 82% of patients. Downregulated LOXL2 was demonstrated post-SVR, with overexpression in cirrhotic patients being a potential therapy goal in selected patients. View Full-Text
Keywords: SVR; liver fibrosis; LOXL2; portal hypertension; fibrosis regression SVR; liver fibrosis; LOXL2; portal hypertension; fibrosis regression
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MDPI and ACS Style

Puente, A.; Fortea, J.I.; Posadas, M.; Garcia Blanco, A.; Rasines, L.; Cabezas, J.; Arias Loste, M.T.; Llerena, S.; Iruzubieta, P.; Fábrega, E.; Crespo, J. Changes in Circulating Lysyl Oxidase-Like-2 (LOXL2) Levels, HOMA, and Fibrosis after Sustained Virological Response by Direct Antiviral Therapy. J. Clin. Med. 2019, 8, 1242. https://doi.org/10.3390/jcm8081242

AMA Style

Puente A, Fortea JI, Posadas M, Garcia Blanco A, Rasines L, Cabezas J, Arias Loste MT, Llerena S, Iruzubieta P, Fábrega E, Crespo J. Changes in Circulating Lysyl Oxidase-Like-2 (LOXL2) Levels, HOMA, and Fibrosis after Sustained Virological Response by Direct Antiviral Therapy. Journal of Clinical Medicine. 2019; 8(8):1242. https://doi.org/10.3390/jcm8081242

Chicago/Turabian Style

Puente, Angela, Jose I. Fortea, Miguel Posadas, Agustin Garcia Blanco, Laura Rasines, Joaquin Cabezas, Maria T. Arias Loste, Susana Llerena, Paula Iruzubieta, Emilio Fábrega, and Javier Crespo. 2019. "Changes in Circulating Lysyl Oxidase-Like-2 (LOXL2) Levels, HOMA, and Fibrosis after Sustained Virological Response by Direct Antiviral Therapy" Journal of Clinical Medicine 8, no. 8: 1242. https://doi.org/10.3390/jcm8081242

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