WO2020175719A1 - Composition for predicting prognosis of severe alcoholic hepatitis, and use thereof - Google Patents
Composition for predicting prognosis of severe alcoholic hepatitis, and use thereof Download PDFInfo
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- WO2020175719A1 WO2020175719A1 PCT/KR2019/002392 KR2019002392W WO2020175719A1 WO 2020175719 A1 WO2020175719 A1 WO 2020175719A1 KR 2019002392 W KR2019002392 W KR 2019002392W WO 2020175719 A1 WO2020175719 A1 WO 2020175719A1
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- G—PHYSICS
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- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/74—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving hormones or other non-cytokine intercellular protein regulatory factors such as growth factors, including receptors to hormones and growth factors
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
- G01N33/576—Immunoassay; Biospecific binding assay; Materials therefor for hepatitis
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- G—PHYSICS
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- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
- G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
- G01N2333/475—Assays involving growth factors
- G01N2333/485—Epidermal growth factor [EGF] (urogastrone)
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- G—PHYSICS
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- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/52—Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis
Definitions
- the present invention relates to a composition for predicting prognosis of severe alcoholic hepatitis and a method of detecting a biomarker to provide information necessary for predicting the prognosis of severe alcoholic hepatitis.
- Alcoholic hepatitis is one of the alcoholic liver diseases that show sudden impairment of liver function due to the destruction of hepatocytes and inflammatory reactions caused by excessive drinking for a long time.
- SAH severe alcoholic hepatitis
- the short-term mortality rate within one month of the invention reaches 40%.
- the mDF Mode Discriminant Function
- severe alcoholic hepatitis As an index for predicting the prognosis of such severe alcoholic hepatitis, in the conventional case, the mDF (Modified Discriminant Function) score is 32 points or higher or the case with hepatic encephalopathy is defined as severe alcoholic hepatitis, which means that the mDF score is less than 32 points.
- the patient's 28-day survival rate is 90%, whereas when the mDF score is 32 or higher, the patient's 28-day survival rate is 50-65%, showing a poor prognosis.
- Such an index for predicting the prognosis of severe alcoholic hepatitis is of great significance because selecting a treatment target by predicting the prognosis of alcoholic hepatitis patients early plays an important role in improving the prognosis of patients.
- MELD Model for End Stage Liver Disease
- GAHS Glasgow Alcoholic Hepatitis Score
- ABIC Age, Bilirubin, INR, Creatinine
- MFG-E8 (Milk fat globule-EGF factor 8) is a protein that functions as a key factor that inhibits fibrosis of liver tissue. In addition, it binds to phosphatidylserine exposed on the surface of apoptotic cells to prevent apoptosis.
- MFG-E8 MMFG-E8 protein
- Prior literature on the technology includes a composition for preventing or treating tissue fibrosis using "Milk fat globule-EGF factor 8 (MFG-E8)" in Korean Patent Application Publication No. 10-2017-0013621 (hereinafter referred to as'prior art') There is this.
- the present invention was created to solve the above problems, and an object of the present invention is to reveal that the MFG-E8 protein has a use as a biomarker for predicting the prognosis of severe alcoholic hepatitis, and at the same time, the prognosis of conventional severe alcoholic hepatitis It is to provide a composition for predicting the prognosis of severe alcoholic hepatitis, including a preparation for detecting a biomarker having excellent short-term prognosis predictive ability and long-term prognosis predictive ability compared to predictive indicators.
- Another object of the present invention is to provide information necessary for predicting the prognosis of severe alcoholic hepatitis by detecting MFG-E8 protein, which has a use as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
- the composition for predicting the prognosis of severe alcoholic hepatitis according to the present invention is MFG-E8 (Milk fat globule-) as a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) in a serum sample. It includes an agent for detecting EGF factor 8).
- the method of detecting a biomarker in order to provide information necessary for predicting the prognosis of severe alcoholic hepatitis according to the present invention is the prognosis of severe alcoholic hepatitis (SAH) from a serum sample derived from a test subject.
- SAH severe alcoholic hepatitis
- a step of detecting the concentration of MFG-E8 (Milk fat globule-EGF factor 8) which is a biomarker for predicting B step of detecting the concentration of bilirubin from the serum sample derived from the test subject;
- the concentration of bilirubin substituted in Equation 1 may be less than 2mg/dL in order to calculate the expected MFG-E8 value through step C among the concentrations of bilirubin detected through step B.
- MFG-E8 Milk fat globule-EGF factor 8
- SAH severe alcoholic hepatitis
- MFG-E8 as a biomarker to predict the prognosis of severe alcoholic hepatitis, compared to the conventional indicators for predicting the prognosis of severe alcoholic hepatitis, has low invasiveness, is easily obtainable, and is highly alcoholic with ease of use. Biomarkers for predicting the prognosis of hepatitis can be used.
- MFG-E8 as a biomarker for predicting the prognosis of alcoholic hepatitis, it can provide accurate and reliable information necessary for predicting the prognosis of severe alcoholic hepatitis.
- FIG. 1 is a graph showing the results of LT-free survival analysis of all test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
- FIG. 2 is a graph showing the results of LT-free survival analysis for each group of test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
- FIG. 3 is a graph showing the distribution and average value analysis results of MFG-E8 protein concentrations for all subjects and groups set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
- Figure 4 shows the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. This is the graph shown.
- Figure 5 is a test subject MFG-E8 protein concentration and GGT (gamma-glutamyltransferase) concentration set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing the correlation between the concentrations of.
- GGT gamma-glutamyltransferase
- Figure 6 shows the concentration of the MFG-E8 protein and the Model for End-stage Liver Disease (MELD) score of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing the correlation between concentrations.
- MELD Model for End-stage Liver Disease
- MFG- of the group (n 32, 22.1%) of Serum Bilirubin ⁇ 2mg/dL among test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
- This is a graph showing the correlation between the E8 protein concentration and the concentration of bilirubin.
- Figure 8 is a distribution and average value analysis results of the expected MFG-E8 protein concentration (pMFG-E8) of all subjects and groups set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing.
- MFG-E8 protein concentration of a test subject is a correlation between the MFG-E8 protein concentration of a test subject and the expected MFG-E8 protein concentration (pMFG-E8) set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis This is a graph showing the correlation.
- Figure 10 is a subgroup analysis of each of four groups classified according to the MFG-E8/pMFG-E8 ratio of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis ( This is a graph showing the result of subgroup analysis.
- 11 is a LT-free for each of four groups classified according to the MFG-E8/pMFG-E8 ratio of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. This is a graph showing the results of the survival rate analysis.
- Figure 12 is a set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis, two categorized according to the MFG-E8/pMFG-E8 ratio of the severe alcoholic hepatitis patient group in the test subject. This is a graph showing the results of LT-free survival rate analysis for each group.
- composition for predicting the prognosis of severe alcoholic hepatitis 1. Description of the composition for predicting the prognosis of severe alcoholic hepatitis
- composition for predicting the prognosis of severe alcoholic hepatitis includes a preparation for detecting a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) in a serum sample of a test subject.
- SAH severe alcoholic hepatitis
- the biomarker for predicting the prognosis of Severe Alcoholic Hepatitis corresponds to MFG-E8 (Milk fat globule-EGF factor 8) present in a serum sample of a test subject.
- the prognosis of severe alcoholic hepatitis of the test subject is more accurately predicted than in the prior art through the concentration of the MFG-E8 protein present in the serum sample of the test subject, and based on this, the presence or absence of the treatment target of the test subject is determined early. You can definitely decide.
- the MFG-E8 protein mediates the phagocytosis of dead cells, is involved in the formation of angiogenesis, promotes hepatocyte proliferation and blood vessel regeneration, and provides a function of reducing tissue fibrosis.
- MFG-E8 protein as a biomarker for predicting the prognosis of severe alcoholic hepatitis
- MFG-E8 protein as a biomarker for predicting the prognosis of severe alcoholic hepatitis
- the experimenter performing the method detects the concentration of MFG-E8 (Milk fat globule-EGF factor 8) from a plurality of test subjects (patients)-derived serum samples (biological samples), respectively (step A).
- MFG-E8 Melk fat globule-EGF factor 8
- step B the concentration of bilirubin is detected from the serum samples derived from a plurality of test subjects.
- each bilirubin concentration value detected from the serum sample derived from the test subject is substituted into [Equation 1] below to calculate expected MFG-E8 (pMFG-E8 Level, Prediected MFG-E8 Level) (step C).
- step D MFG using information on the expected MFG-E8 value calculated based on each bilirubin concentration value detected from a serum sample derived from a test subject and information on the concentration value of MFG-E8 protein detected from a serum sample derived from the test subject. -Calculate the ratio of the FG-E8 protein concentration value to the expected E8 value (step D).
- the concentration of bilirubin substituted in [Equation 1] for calculating the expected MFG-E8 value is preferably less than 2mg/dL.
- the experimenter has the prognosis for Severe Alcoholic Hepatitis (SAH) as long as the ratio of the FG-E8 protein concentration value to the expected MFG-E8 value calculated for multiple test subjects is less than 0.3. Is expected to be poor.
- SAH Severe Alcoholic Hepatitis
- MFG-E8 Milk fat globule-EGF factor 8
- MFG-E8 is a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) according to the present invention. This will be described in detail.
- milk fat globule-EGF factor 8 (MFG-E8) of the present invention as a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH).
- Tests such as LT-free survival, Cox-regression analysis, and Pearson's correlation analysis were performed using 138 patients as test subjects, and this test is for the purpose of defining properties by means obvious to those skilled in the art. The following experimental methods were used.
- Table 1 shows the overall and group-based characteristics of the test subject.
- P indicated in Table 1 below means a P-value value.
- the results of analyzing the LT-free survival (Liver transplantation-free survival) of the severe alcoholic hepatitis patient group and the other control group having such basic characteristics are as shown in FIGS. 1 and 2.
- test subjects died after 1 year from the time point at which blood was collected from each test subject to obtain a serum sample, and 5 test subjects had livers that do not recover. He had a liver transplant due to insufficiency.
- the concentration value of the MFG-E8 protein was measured from the serum samples of all of the test subjects and each of the groups, and the average value of the total and each group was calculated to obtain a result as shown in FIG. 3.
- the average concentration of MFG-E8 protein in the serum sample of the whole test subject is 6.8 ⁇ 5.8 ng/mL
- the average concentration of MFG-E8 protein in the serum sample of the severe alcoholic hepatitis patient group is 8.5 ⁇ 5.2 ng/mL
- the concentration of MFG-E8 protein in the serum sample of the test subject is significant with the concentration of bilirubin, GGT (gamma-glutamyltransferase), and plasma sodium. Showed a relevance.
- the concentration of MFG-E8 protein in the serum sample of the test subject was significantly related to the concentration of bilirubin and GGT (gamma-glutamyltransferase) as a result of multivariate linear regression analysis. Can be seen.
- the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin in a serum sample of a test subject shows a significant relationship.
- the average value of the expected MFG-E8 concentration (pMFG-E8) calculated for the entire test subject is 14.8 ⁇ 15.6 ng/mL, calculated for the alcoholic hepatitis patient group (Pts with SAH) as shown in FIG.
- the average value of the expected MFG-E8 concentration (pMFG-E8) is 25.2 ⁇ 19.3 ng/mL
- the average value of the expected MFG-E8 concentration (pMFG-E8) calculated for the remaining control group is 8.9 ⁇ 8.8 ng/ In mL
- the alcoholic hepatitis patient group (Pts with SAH) showed significant results compared to the control group.
- the detected MFG-E8 compared to the MFG-E8 expected concentration (pMFG-E8) calculated using the detected MFG-E8 protein concentration (mMFG-E8) and the calculated MFG-E8 expected concentration (pMFG-E8).
- the ratio of the protein concentration (mMFG-E8) was calculated, and univariate analysis and multivariate analysis through Cox regression analysis were performed.
- MELD Score HR, 1.060; 95% CI, 1.033-1.088; P ⁇ 0.001
- serum MFG-E8 is secreted according to the degree of cholestasis and aggravates the disease through anti-inflammatory mechanisms.
- SAH severe alcoholic hepatitis
- the concentration of MFG-E8 in the serum is an important biomarker in predicting the prognosis of severe alcoholic hepatitis.
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Abstract
The present invention relates to a composition for predicting the prognosis of Severe Alcoholic Hepatitis (SAH), and comprises a formulation for detecting Milk fat globule-EGF factor 8 (MFG-E8) as a biomarker for predicting the prognosis of SAH in a serum sample.
Description
본 발명은 중증 알코올성 간염 예후 예측용 조성물 및 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하기 위하여 바이오마커를 검출하는 방법에 관한 것이다.The present invention relates to a composition for predicting prognosis of severe alcoholic hepatitis and a method of detecting a biomarker to provide information necessary for predicting the prognosis of severe alcoholic hepatitis.
알코올성 간염은 장기간 과도하게 진행된 음주에 의해 간세포가 파괴되고 염증 반응이 동반되어 급격한 간기능의 장애를 보이는 알코올성 간질환의 하나로서, 이 중 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)은 예후가 매울 불량하여 발명 1개월 이내의 단기 사망률이 40%에 이른다.Alcoholic hepatitis is one of the alcoholic liver diseases that show sudden impairment of liver function due to the destruction of hepatocytes and inflammatory reactions caused by excessive drinking for a long time.Severe alcoholic hepatitis (SAH) has a very poor prognosis. Thus, the short-term mortality rate within one month of the invention reaches 40%.
이러한 중증 알코올성 간염의 예후를 예측하기 위한 지표로서, 종래의 일반적인 경우 mDF(Modified Discriminant Function) 점수가 32점 이상이거나 간성 뇌증을 동반한 경우로 중증 알코올성 간염으로 정의하며, 이는 mDF 점수가 32점 미만일 경우 환자의 28일 생존율이 90%인데 반해, mDF 점수가 32점 이상일 경우에는 환자의 28일 생존률이 50-65%로 불량한 예후를 보이기 때문이다.As an index for predicting the prognosis of such severe alcoholic hepatitis, in the conventional case, the mDF (Modified Discriminant Function) score is 32 points or higher or the case with hepatic encephalopathy is defined as severe alcoholic hepatitis, which means that the mDF score is less than 32 points. In this case, the patient's 28-day survival rate is 90%, whereas when the mDF score is 32 or higher, the patient's 28-day survival rate is 50-65%, showing a poor prognosis.
이와 같은 중증 알코올성 간염의 예후를 예측하기 위한 지표는 알코올성 간염 환자의 예후를 조기에 예측하여 치료 대상을 선정하는 것이 환자의 예후를 향상시킴에 중요한 역할을 하기 때문에 큰 의미를 가진다.Such an index for predicting the prognosis of severe alcoholic hepatitis is of great significance because selecting a treatment target by predicting the prognosis of alcoholic hepatitis patients early plays an important role in improving the prognosis of patients.
더 나아가, 중증 알코올성 간염의 예후를 예측하기 위한 지표로서 종래에는 MELD (Model for End Stage Liver Disease) 점수, Glasgow 알코올간염 점수(Glasgow Alcoholic Hepatitis Score, GAHS)와 ABIC (Age, Bilirubin, INR, Creatinine) 점수 등이 있다.Furthermore, as an indicator to predict the prognosis of severe alcoholic hepatitis, conventionally, MELD (Model for End Stage Liver Disease) score, Glasgow Alcoholic Hepatitis Score (GAHS) and ABIC (Age, Bilirubin, INR, Creatinine) And scores.
이러한 종래의 중증 알코올성 간염의 예후를 예측하기 위한 지표들은 다양한 연구들이 진행 중이나, 각 연구마다 예후 평가에 유용한 절단값의 차이를 보이거나 단기 예후의 예측능에 비해 장기 예후 예측능이 낮은 문제점이 있었다.These conventional indicators for predicting the prognosis of severe alcoholic hepatitis are various studies in progress, but each study shows a difference in the cutoff value useful for prognostic evaluation, or there is a problem in that the long-term prognosis predictability is low compared to the short-term prognosis.
한편, MFG-E8(Milk fat globule-EGF factor 8)은 간조직의 섬유화를 억제하는 핵심 인자로 기능하는 단백질로서, 이 외에도 세포사멸 세포의 표면에 노출된 포스파티딜세린과 결합하여 세포사멸 세포의 옵소닌 작용과 식세포의 표면에 있는 인터그린과의 결합을 통해 죽은 세포의 포식을 매개하는 기능, Toll like receptor 4 signaling pathway를 차단하여 pre-inflammatory cytokine의 분비를 저하시키는 기능, 축적된 콜라겐을 제거하거나 상피세포의 사멸을 억제하는 기능 또는 신생혈관 형성에 관여하는 기능 등에도 연구된 바 있다.On the other hand, MFG-E8 (Milk fat globule-EGF factor 8) is a protein that functions as a key factor that inhibits fibrosis of liver tissue. In addition, it binds to phosphatidylserine exposed on the surface of apoptotic cells to prevent apoptosis. The function of mediating the phagocytosis of dead cells through sonication and binding with intergreen on the surface of phagocytes, the function of reducing the secretion of pre-inflammatory cytokines by blocking the Toll like receptor 4 signaling pathway, and removing accumulated collagen It has also been studied for the function of inhibiting the death of epithelial cells or the function involved in the formation of angiogenesis.
더욱이, MFG-E8 단백질의 다양한 기능 중 간세포 증식 및 혈관 재생 촉진을 통해 간재생 및 간질환 개선과 관련된 기능의 제공이 가능함은 물론이고, 간조직의 섬유화 감소와 관련된 기능의 제공이 가능함과 관련된 종래기술에 대한 선행문헌에는 대한민국 공개특허공보 제10-2017-0013621호의"Milk fat globule-EGF factor 8 (MFG-E8)을 이용한 조직섬유화 예방 또는 치료용 조성물"(이하, '종래기술'이라고 함)이 있다.Moreover, among the various functions of the MFG-E8 protein, it is possible to provide functions related to liver regeneration and liver disease improvement by promoting hepatocyte proliferation and blood vessel regeneration, as well as providing functions related to reduction of fibrosis in liver tissue. Prior literature on the technology includes a composition for preventing or treating tissue fibrosis using "Milk fat globule-EGF factor 8 (MFG-E8)" in Korean Patent Application Publication No. 10-2017-0013621 (hereinafter referred to as'prior art') There is this.
이러한 종래기술을 비롯한 기존의 MFG-E8 단백질이 제공 가능한 다양한 기능적 역할에 관한 기술들은 특정 증상의 예방 혹은 치료를 위한 작용 기전에 MFG-E8 단백질이 주요 역할을 수행하고 있음을 밝히고 있을 뿐, 특정 질환의 예후를 예측하기 위한 이용하기 위한 용도로 이용 가능함을 밝히고 있지 아니하다.The technologies related to the various functional roles that the existing MFG-E8 protein can provide, including these prior art, only reveal that the MFG-E8 protein plays a major role in the mechanism of action for the prevention or treatment of specific symptoms. It is not disclosed that it can be used for the purpose of predicting the prognosis of.
구체적으로, 이러한 종래기술을 비롯한 기존의 MFG-E8 단백질이 제공 가능한 다양한 기능적 역할에 관한 기술들은 MFG-E8 단백질이 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 종래의 지표들과 확연한 차이를 보이며 더욱 정확한 중증 알코올성 간염의 예후 예측용 바이오마커로서의 용도를 갖추고 있음을 밝히고 있지 아니하다.Specifically, technologies related to the various functional roles that the existing MFG-E8 protein can provide, including these prior art, are known as conventional indicators for predicting the prognosis of Severe Alcoholic Hepatitis (SAH) and MFG-E8 protein. It shows a clear difference and does not reveal that it has a use as a biomarker for predicting the prognosis of more accurate severe alcoholic hepatitis.
본 발명은 상기 문제점을 해결하기 위해 창작된 것으로써, 본 발명의 목적은 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측을 위한 바이오 마커로서의 용도를 갖추고 있음을 밝힘과 동시에 종래의 중증 알코올성 간염의 예후 예측을 위한 지표들에 비해 단기 예후 예측능 및 장기 예후 예측능이 우수한 바이오 마커를 검출하기 위한 제제를 포함한 중증 알코올성 간염 예후 예측용 조성물을 제공하는데 있다.The present invention was created to solve the above problems, and an object of the present invention is to reveal that the MFG-E8 protein has a use as a biomarker for predicting the prognosis of severe alcoholic hepatitis, and at the same time, the prognosis of conventional severe alcoholic hepatitis It is to provide a composition for predicting the prognosis of severe alcoholic hepatitis, including a preparation for detecting a biomarker having excellent short-term prognosis predictive ability and long-term prognosis predictive ability compared to predictive indicators.
또한, 본 발명의 다른 목적은 중증 알코올성 간염의 예후 예측을 위한 바이오 마커로서의 용도를 갖춘 MFG-E8 단백질을 검출해 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하는데 있다.In addition, another object of the present invention is to provide information necessary for predicting the prognosis of severe alcoholic hepatitis by detecting MFG-E8 protein, which has a use as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
상기 목적을 달성하기 위하여 본 발명에 따른 심중증 알코올성 간염 예후 예측용 조성물은, 혈청 시료 내 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오마커로서 MFG-E8(Milk fat globule-EGF factor 8)를 검출하기 위한 제제를 포함한다.In order to achieve the above object, the composition for predicting the prognosis of severe alcoholic hepatitis according to the present invention is MFG-E8 (Milk fat globule-) as a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) in a serum sample. It includes an agent for detecting EGF factor 8).
한편, 상기 목적을 달성하기 위하여 본 발명에 따른 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하기 위하여 바이오마커를 검출하는 방법은, 검사 대상체 유래 혈청 시료로부터 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커인 MFG-E8(Milk fat globule-EGF factor 8)의 농도를 검출하는 A단계; 상기 검사 대상체 유래 혈청 시료로부터 빌리루빈(Bilirubin)의 농도를 검출하는 B단계; 상기 B단계를 통해 검출된 빌리루빈의 농도를 하기 수학식 1에 대입하여 MFG-E8 기댓값을 산출하는 C단계; 상기 C단계를 통해 산출된 MFG-E8 기댓값 대비 상기 A단계를 통해 검출된 MFG-E8 농도값의 비율을 산출하는 D단계; 및 상기 D단계를 통해 산출된 MFG-E8 기댓값 대비 상기 검사 대상체 유래 혈청 시료 내 MFG-E8 농도값의 비율이 0.3 미만일 경우 상기 검사 대상체는 중증 알코올성 간염의 예후가 불량할 것으로 예측하는 E단계;를 포함한다.On the other hand, in order to achieve the above object, the method of detecting a biomarker in order to provide information necessary for predicting the prognosis of severe alcoholic hepatitis according to the present invention is the prognosis of severe alcoholic hepatitis (SAH) from a serum sample derived from a test subject. A step of detecting the concentration of MFG-E8 (Milk fat globule-EGF factor 8) which is a biomarker for predicting B step of detecting the concentration of bilirubin from the serum sample derived from the test subject; Step C of calculating an expected MFG-E8 value by substituting the concentration of bilirubin detected in step B into Equation 1 below; D step of calculating a ratio of the concentration value of MFG-E8 detected through the step A to the expected value of MFG-E8 calculated through the step C; And step E of predicting that the test subject will have a poor prognosis of severe alcoholic hepatitis when the ratio of the MFG-E8 concentration value in the serum sample derived from the test subject to the expected MFG-E8 value calculated through step D is less than 0.3; Include.
여기서, [수학식 1]은 'MFG-E8 기댓값(pMFG-E8 Level, Prediected MFG-E8 Level)=1.527+1.841×빌리루빈(Bilirubin)의 농도값'에 해당한다.Here, [Equation 1] corresponds to'the expected value of MFG-E8 (pMFG-E8 Level, Prediected MFG-E8 Level) = 1.527 + 1.841 × concentration of bilirubin'.
또한, 상기 B단계를 통해 검출된 빌리루빈의 농도 중 상기 C단계를 통해 MFG-E8 기댓값을 산출하기 위해 상기 수학식 1에 대입되는 빌리루빈의 농도는 2mg/dL 미만일 수 있다.In addition, the concentration of bilirubin substituted in Equation 1 may be less than 2mg/dL in order to calculate the expected MFG-E8 value through step C among the concentrations of bilirubin detected through step B.
본 발명에 의하면 다음과 같은 효과가 있다.According to the present invention, there are the following effects.
첫째, MFG-E8(Milk fat globule-EGF factor 8)을 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커의 용도로 이용하여 종래의 중증 알코올성 간염 예후 예측용 지표에 비해 더욱 정확하고 확실한 중증 알코올성 간염 예후 예측 성능의 제공이 가능하다.First, MFG-E8 (Milk fat globule-EGF factor 8) was used as a biomarker to predict the prognosis of severe alcoholic hepatitis (SAH), compared to the conventional indicators for predicting the prognosis of severe alcoholic hepatitis. It is possible to provide accurate and reliable predictive performance for severe alcoholic hepatitis prognosis.
둘째, MFG-E8을 중증 알코올성 간염의 예후를 예측하기 위한 바이오 마커의 용도로 이용하여 종래의 중증 알코올성 간염 예후 예측용 지표에 비해 침습도가 낮고, 용이하게 수득 가능하며, 이용 편의성을 갖춘 중증 알코올성 간염 예후 예측용 바이오 마커의 이용이 가능하다.Second, the use of MFG-E8 as a biomarker to predict the prognosis of severe alcoholic hepatitis, compared to the conventional indicators for predicting the prognosis of severe alcoholic hepatitis, has low invasiveness, is easily obtainable, and is highly alcoholic with ease of use. Biomarkers for predicting the prognosis of hepatitis can be used.
셋째, MFG-E8을 알코올성 간염의 예후를 예측하기 위한 바이오 마커로서 검출하여 중증 알코올성 간염 예후 예측에 필요한 정확하고 신뢰도가 높은 정보를 제공할 수 있다.Third, by detecting MFG-E8 as a biomarker for predicting the prognosis of alcoholic hepatitis, it can provide accurate and reliable information necessary for predicting the prognosis of severe alcoholic hepatitis.
도1은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체 전체의 LT-free survival 분석결과를 나타낸 그래프이다.1 is a graph showing the results of LT-free survival analysis of all test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
도2는 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 군별 LT-free survival 분석결과를 나타낸 그래프이다.2 is a graph showing the results of LT-free survival analysis for each group of test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
도3은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체 전체 및 군별 MFG-E8 단백질 농도의 분포 및 평균값 분석결과를 나타낸 그래프이다.3 is a graph showing the distribution and average value analysis results of MFG-E8 protein concentrations for all subjects and groups set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis.
도4는 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8 단백질 농도와 빌리루빈(Bilirubin)의 농도 간의 상관관계(correlation)를 나타낸 그래프이다.Figure 4 shows the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. This is the graph shown.
도5는 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8 단백질 농도와 GGT(감마글루타밀전이효소, Gamma-glutamyltransferase) 농도의 농도 간의 상관관계(correlation)를 나타낸 그래프이다.Figure 5 is a test subject MFG-E8 protein concentration and GGT (gamma-glutamyltransferase) concentration set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing the correlation between the concentrations of.
도6은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8 단백질 농도와 MELD(Model for End-stage Liver Disease) score 농도의 농도 간의 상관관계(correlation)를 나타낸 그래프이다.Figure 6 shows the concentration of the MFG-E8 protein and the Model for End-stage Liver Disease (MELD) score of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing the correlation between concentrations.
도7은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체 중 Serum Bilirubin <2mg/dL인 군(n=32, 22.1%)의 MFG-E8 단백질 농도와 빌리루빈(Bilirubin)의 농도 간의 상관관계(correlation)를 나타낸 그래프이다.7 is MFG- of the group (n=32, 22.1%) of Serum Bilirubin <2mg/dL among test subjects set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. This is a graph showing the correlation between the E8 protein concentration and the concentration of bilirubin.
도8은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체 전체 및 군별 MFG-E8 단백질 기대 농도(pMFG-E8)의 분포 및 평균값 분석결과를 나타낸 그래프이다.Figure 8 is a distribution and average value analysis results of the expected MFG-E8 protein concentration (pMFG-E8) of all subjects and groups set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. It is a graph showing.
도9는 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8 단백질 농도와 MFG-E8 단백질 기대 농도(pMFG-E8) 간의 상관관계(correlation)를 나타낸 그래프이다.9 is a correlation between the MFG-E8 protein concentration of a test subject and the expected MFG-E8 protein concentration (pMFG-E8) set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis This is a graph showing the correlation.
도10은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8/pMFG-E8 ratio에 따라 분류된 4개의 각 군별 아군 분석(Subgroup analysis)결과를 나타낸 그래프이다.Figure 10 is a subgroup analysis of each of four groups classified according to the MFG-E8/pMFG-E8 ratio of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis ( This is a graph showing the result of subgroup analysis.
도11은 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체의 MFG-E8/pMFG-E8 ratio에 따라 분류된 4개의 각 군별 LT-free survival rate 분석결과를 나타낸 그래프이다.11 is a LT-free for each of four groups classified according to the MFG-E8/pMFG-E8 ratio of a test subject set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis. This is a graph showing the results of the survival rate analysis.
도12는 본 발명의 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능함을 검증하기 위해 설정된 검사 대상체 내 중증 알코올성 간염 환자군의 MFG-E8/pMFG-E8 ratio에 따라 분류된 2개의 각 군별 LT-free survival rate 분석결과를 나타낸 그래프이다.Figure 12 is a set to verify that the MFG-E8 protein of the present invention can function as a biomarker for predicting the prognosis of severe alcoholic hepatitis, two categorized according to the MFG-E8/pMFG-E8 ratio of the severe alcoholic hepatitis patient group in the test subject. This is a graph showing the results of LT-free survival rate analysis for each group.
본 발명의 바람직한 실시예에 대하여 첨부된 도면을 참조하여 더 구체적으로 설명하되, 이미 주지된 기술적 부분에 대해서는 설명의 간결함을 위해 생략하거나 압축하기로 한다.Preferred embodiments of the present invention will be described in more detail with reference to the accompanying drawings, but technical parts that are already well known will be omitted or compressed for conciseness of description.
1. 중증 알코올성 간염 예후 예측용 조성물에 관한 설명1. Description of the composition for predicting the prognosis of severe alcoholic hepatitis
본 발명에 따른 중증 알코올성 간염 예후 예측용 조성물은 검사 대상체의 혈청 시료 내 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커를 검출하기 위한 제제를 포함한다.The composition for predicting the prognosis of severe alcoholic hepatitis according to the present invention includes a preparation for detecting a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) in a serum sample of a test subject.
여기서, 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커는 검사 대상체의 혈청 시료 내 존재하는 MFG-E8(Milk fat globule-EGF factor 8)에 해당한다.Here, the biomarker for predicting the prognosis of Severe Alcoholic Hepatitis (SAH) corresponds to MFG-E8 (Milk fat globule-EGF factor 8) present in a serum sample of a test subject.
다시 말해, 검사 대상체의 혈청 시료 내 존재하는 MFG-E8 단백질의 농도를 통해 검사 대상체의 중증 알코올성 간염의 예후를 종래에 비해 더욱 정학하게 예측하고, 이를 기반으로 검사 대상체의 치료 대상 선별 유무를 조기에 확실히 정할 수 있게 된다.In other words, the prognosis of severe alcoholic hepatitis of the test subject is more accurately predicted than in the prior art through the concentration of the MFG-E8 protein present in the serum sample of the test subject, and based on this, the presence or absence of the treatment target of the test subject is determined early. You can definitely decide.
이와 관련하여, MFG-E8 단백질은 죽은 세포의 포식을 매개하거나, 신생혈관 형성에 관여하거나, 간세포 증식 및 혈관 재생을 촉진하거나, 조직 섬유화의 감소화 기능을 제공하는 등 다양한 기능성에 관한 연구 및 기술들일 제시되어 왔으나. 아직까지 염증 작용을 주요 기전으로 하는 중증 알코올성 간염의 예후를 예측함에 MFG-E8 단백질의 발현 정도가 관여하는 용도적 특성에 관해는 알려진 바가 없었다.In this regard, the MFG-E8 protein mediates the phagocytosis of dead cells, is involved in the formation of angiogenesis, promotes hepatocyte proliferation and blood vessel regeneration, and provides a function of reducing tissue fibrosis. Although it has been proposed. Until now, there has been no known information on the useful properties of the expression level of MFG-E8 protein in predicting the prognosis of severe alcoholic hepatitis, which is the main mechanism of inflammatory action.
따라서 중증 알코올성 간염의 예후 예측에 필요한 정보를 제공하기 위해 MFG-E8 단백질을 중증 알코올성 간염의 예후를 예측하기 위한 바이오 마커로서 검출하는 방법 및 MFG-E8 단백질이 중증 알코올성 간염의 예후 예측용 바이오 마커로서 기능 가능한 용도적 특성 및 의의를 갖추고 있음을 검증한 시험 결과에 관해 아래 구체적으로 설명하고자 한다.Therefore, in order to provide information necessary for predicting the prognosis of severe alcoholic hepatitis, a method of detecting MFG-E8 protein as a biomarker for predicting the prognosis of severe alcoholic hepatitis, and MFG-E8 protein as a biomarker for predicting the prognosis of severe alcoholic hepatitis The following is a detailed description of the test results that have been verified to have functional characteristics and significance.
2. 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하기 위하여 바이오마커를 검출하는 방법2. A method of detecting biomarkers to provide information necessary to predict the prognosis of severe alcoholic hepatitis
본 발명에 따른 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하기 위하여 바이오마커를 검출하는 방법이 이루어지는 과정에 대해 상세하게 설명한다.In order to provide information necessary for predicting the prognosis of severe alcoholic hepatitis according to the present invention, a process in which a method of detecting a biomarker is performed will be described in detail.
우선, 해당 방법을 진행하는 실험자는 다수의 검사 대상체(환자) 유래 혈청 시료(생물학적 시료)로부터 MFG-E8(Milk fat globule-EGF factor 8)의 농도를 각각 검출(A단계)한다.First, the experimenter performing the method detects the concentration of MFG-E8 (Milk fat globule-EGF factor 8) from a plurality of test subjects (patients)-derived serum samples (biological samples), respectively (step A).
다음으로, 다수의 검사 대상체 유래 혈청 시료로부터 빌리루빈(Bilirubin)의 농도를 각각 검출(B단계)한다.Next, the concentration of bilirubin is detected from the serum samples derived from a plurality of test subjects (step B).
여기서, 검출되는 각각의 빌리루빈 농도값 중 빌리루빈의 농도값이 2mg/dL 미만인 검사 대상체만이 추후 진행될 MFG-E8 기댓값 산출 단계를 진행함이 바람직하다.Here, it is preferable that only the test subject whose concentration value of bilirubin is less than 2 mg/dL among the detected concentration values of bilirubin performs the MFG-E8 expected value calculation step to be performed later.
다음으로, 검사 대상체 유래 혈청 시료로부터 검출된 각각의 빌리루빈 농도값을 아래 [수학식 1]에 대입하여 MFG-E8 기댓값(pMFG-E8 Level, Prediected MFG-E8 Level)을 산출(C단계)한다.Next, each bilirubin concentration value detected from the serum sample derived from the test subject is substituted into [Equation 1] below to calculate expected MFG-E8 (pMFG-E8 Level, Prediected MFG-E8 Level) (step C).
다음으로, 검사 대상체 유래 혈청 시료로부터 검출된 각각의 빌리루빈 농도값을 기반으로 산출된 MFG-E8 기댓값에 관한 정보와 검사 대상체 유래 혈청 시료로부터 검출된 MFG-E8 단백질의 농도값에 관한 정보를 이용해 MFG-E8 기댓값 대비 FG-E8 단백질 농도값의 비율을 산출(D단계)한다.Next, MFG using information on the expected MFG-E8 value calculated based on each bilirubin concentration value detected from a serum sample derived from a test subject and information on the concentration value of MFG-E8 protein detected from a serum sample derived from the test subject. -Calculate the ratio of the FG-E8 protein concentration value to the expected E8 value (step D).
또한, 앞 서 설명한 바와 같이 MFG-E8 기댓값 산출을 위해 [수학식 1]에 대입되는 빌리루빈의 농도는 2mg/dL 미만인 것이 바람직하다.In addition, as described above, the concentration of bilirubin substituted in [Equation 1] for calculating the expected MFG-E8 value is preferably less than 2mg/dL.
마지막으로, 실험자는 다수의 검사 대상체에 대해 산출된 MFG-E8 기댓값 대비 FG-E8 단백질의 농도값의 비율이 0.3 미만일 경우에 한해 해당 검사 대상체가 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)에 대한 예후가 불량할 것으로 예측한다.Lastly, the experimenter has the prognosis for Severe Alcoholic Hepatitis (SAH) as long as the ratio of the FG-E8 protein concentration value to the expected MFG-E8 value calculated for multiple test subjects is less than 0.3. Is expected to be poor.
3. MFG-E8(Milk fat globule-EGF factor 8)의 중증 알코올성 간염 예후 예측용 바이오마커로서의 용도 및 의의 검증 시험 결과에 관한 설명3. Description of the use of MFG-E8 (Milk fat globule-EGF factor 8) as a biomarker for predicting the prognosis of severe alcoholic hepatitis and its significance verification test results
본 발명에 따른 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis) 예후 예측을 위한 바이오 마커에 해당하는 MFG-E8의 용도적 특성 및 의의를 검증하기 위해 수행된 시험의 결과에 대해 도1 내지 도12을 참조하여 상세하게 설명한다.See Figs. 1 to 12 for the results of tests performed to verify the use characteristics and significance of MFG-E8, which is a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) according to the present invention. This will be described in detail.
구체적으로, 본 발명의 Milk fat globule-EGF factor 8(MFG-E8) 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis) 예후 예측을 위한 바이오 마커로서 용도적 특성을 갖추고 있음을 검증하기 위해 알코올성 간염으로 입원한 138명의 환자들을 검사 대상체로 하여 LT-free survival, Cox-regression analysis, Pearson's correlation analysis 등의 시험을 수행하였으며, 해당 시험은 당업계의 기술자들에게 자명한 수단에 의한 성질 등을 정의하기 위한 목적으로 하기 실험 방법들을 이용하였다. Specifically, milk fat globule-EGF factor 8 (MFG-E8) of the present invention as a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH). Tests such as LT-free survival, Cox-regression analysis, and Pearson's correlation analysis were performed using 138 patients as test subjects, and this test is for the purpose of defining properties by means obvious to those skilled in the art. The following experimental methods were used.
우선, 알코올성 간염으로 입원한 138명의 환자들을 검사 대상체 전체로 설정하고, 이 중 mDF(Modified Discriminant Function) 점수가 32점 이상인 환자를 중증 알코올성 간염 환자군(Pts(Patents) with SAH)으로서 설정하고 나머지를 대조군(Pts(Patents) without SAH)으로 분류 설정하였다.First, 138 patients hospitalized for alcoholic hepatitis were set as the entire test subject, and among them, patients with a Modified Discriminant Function (mDF) score of 32 or higher were set as the severe alcoholic hepatitis patient group (Pts (Patents) with SAH), and the rest It was classified as a control group (Pts(Patents) without SAH).
이에 따라 52명(35.9%)의 검사 대상체는 중증 알코올성 간염 환자군(Pts(Patents) with SAH)으로 분류되었고, 93명(64.1%)의 검사 대상체는 대조군(Pts(Patents) without SAH)으로 분류되었다. Accordingly, 52 subjects (35.9%) were classified into the severe alcoholic hepatitis patient group (Pts(Patents) with SAH), and 93 subjects (64.1%) were classified as the control subjects (Pts(Patents) without SAH). .
다음으로, 이와 같이 분류된 각 군의 검사 대상체 각각으로부터 유래되어 -80℃ Deep Freezer에 보관된 각각의 혈청 시료 및 환자 정보를 이용해 나이, 남성 수 및 비율, 혈소판수(Platelet count), INR(혈액응고수치) AST(아스파테이트 아미노전이효소, aspartate aminotransferase) 농도, ALT(알라닌 아미노전이효소, alanine aminotransferse) 농도, 빌리루빈(bilirubin) 농도, 알부민(Albumin) 농도, GGT(감마글루타밀전이효소, Gamma-glutamyltransferase) 농도, 크레아티닌크레아티닌(Creatinine) 농도, 혈장 나트륨(Sodium) 농도, MELD(Model for End-stage Liver Disease) score 등에 대한 정보를 수득한 결과는 하기 표1에 도시된 바와 같다.Next, using each serum sample and patient information derived from each of the test subjects in each group classified as described above and stored in a -80°C Deep Freezer, age, male number and ratio, platelet count, INR (blood Coagulation level) AST (aspartate aminotransferase) concentration, ALT (alanine aminotransferse) concentration, bilirubin concentration, albumin (Albumin) concentration, GGT (gammagglutamyl transferase, Gamma-) The results obtained by obtaining information on glutamyltransferase) concentration, creatinine creatinine concentration, plasma sodium concentration, MELD (Model for End-stage Liver Disease) score, etc. are shown in Table 1 below.
다시 말해, 하기 표1은 검사 대상체의 전체 및 군별 기초 특성 (Baseline characteristics)을 나타내고 있다. In other words, Table 1 below shows the overall and group-based characteristics of the test subject.
또한, 하기 표1 내 표시된 P는 P-value값을 의미한다.In addition, P indicated in Table 1 below means a P-value value.
All pts(n=145)All pts(n=145) | Pts without SAH(n=93)Pts without SAH(n=93) | Pts with SAH(n=52)Pts with SAH(n=52) | PP | |
Age(years)Age(years) | 53.5±10.553.5±10.5 | 55.0±10.755.0±10.7 | 50.8±9.450.8±9.4 | 0.0180.018 |
Male(n(%))Male(n(%)) | 127(87.6)127(87.6) | 82(88.2)82(88.2) | 45(86.5)45(86.5) | 0.7750.775 |
Alcohol(g/day)Alcohol(g/day) | 116.0±71.3116.0±71.3 | 113.2±74.0113.2±74.0 | 121.1±66.7121.1±66.7 | 0.5210.521 |
Platelet count(×10 9/L)Platelet count(×10 9 /L) | 112.5±75.1112.5±75.1 | 118.0±77.2118.0±77.2 | 102.7±71.0102.7±71.0 | 0.2400.240 |
INRINR | 2.2±3.22.2±3.2 | 1.9±2.51.9±2.5 | 2.9±4.02.9±4.0 | 0.0620.062 |
AST(IU/L)AST(IU/L) | 243.9±643.1243.9±643.1 | 173.9±303.5173.9±303.5 | 369.1±988.3369.1±988.3 | 0.1710.171 |
ALT(IU/L)ALT(IU/L) | 108.1±323.2108.1±323.2 | 104.7±350.3104.7±350.3 | 114.0±271.0114.0±271.0 | 0.8690.869 |
Bilirubin(mg/dL)Bilirubin (mg/dL) | 7.2±8.57.2±8.5 | 4.0±4.84.0±4.8 | 12.9±10.512.9±10.5 | <0.001<0.001 |
Albumin(g/dL)Albumin(g/dL) | 2.9±0.62.9±0.6 | 2.9±0.62.9±0.6 | 2.7±0.52.7±0.5 | 0.0920.092 |
GGT(IU/L)GGT(IU/L) | 314.0±438.1314.0±438.1 | 384.5±519.2384.5±519.2 | 187.9±174.2187.9±174.2 | 0.0010.001 |
Creatinine(mg/dL)Creatinine (mg/dL) | 1.2±1.01.2±1.0 | 1.2±1.01.2±1.0 | 1.2±0.91.2±0.9 | 0.9020.902 |
Sodium(mEq/L)Sodium(mEq/L) | 135.8±6.2135.8±6.2 | 136.4±6.0136.4±6.0 | 134.7±6.3134.7±6.3 | 0.1080.108 |
MELD scoreMELD score | 20.6±8.520.6±8.5 | 17.2±6.017.2±6.0 | 26.7±9.026.7±9.0 | <0.001<0.001 |
(pts : patents, SAH : Severe Alcoholic Hepatitis)(pts: patents, SAH: Severe Alcoholic Hepatitis)
이와 같은 기초 특성을 갖춘 중증 알코올성 간염 환자군과 나머지 대조군의 LT-free survival(Liver transplantation-free survival)을 분석한 결과는 도1 및 도2에 도시된 바와 같다. The results of analyzing the LT-free survival (Liver transplantation-free survival) of the severe alcoholic hepatitis patient group and the other control group having such basic characteristics are as shown in FIGS. 1 and 2.
여기서, 도1에 도시된 바와 같이 혈청 시료의 획득을 위해 각각의 검사 대상체로부터 채혈을 진행한 시점을 기준으로 1년이 지난 후 22명의 검사 대상체가 사망하였고, 5명의 검사 대상체는 회복되지 않는 간기능 부전으로 인해 간이식 수술을 받았다.Here, as shown in FIG. 1, 22 test subjects died after 1 year from the time point at which blood was collected from each test subject to obtain a serum sample, and 5 test subjects had livers that do not recover. He had a liver transplant due to insufficiency.
또한, 도2에 도시된 바와 같이 검사 대상체의 군별 LT-free survival 분석 결과를 비교해 보면, LT-free survival 수준은 검사 대상체의 중증 알코올성 간염 여부에 따라 큰 차이를 보이며 중증 알코올성 간염 환자군과 나머지 대조군 간에 유의한 차이를 보였다.(P=0.001)In addition, when comparing the results of the LT-free survival analysis for each group of test subjects as shown in FIG. 2, the LT-free survival level shows a large difference depending on the test subject's severe alcoholic hepatitis, and between the severe alcoholic hepatitis patient group and the rest control group. There was a significant difference (P=0.001).
다음으로, 검사 대상체의 사망 또는 간 이식에 대한 콕스 회기분석(Cox-regression analysis)을 수행하였으며, 이에 따른 단변량 분석 및 다변량 분석 결과는 하기 표2에 도시된 바와 같다.Next, a Cox-regression analysis was performed on the death or liver transplantation of the test subject, and the results of univariate analysis and multivariate analysis accordingly are as shown in Table 2 below.
단변량 분석Univariate analysis | 다변량 분석Multivariate analysis | |||
HR(95% Cl)HR (95% Cl) | PP | HR(95% Cl)HR (95% Cl) | PP | |
AgeAge | 0.971(0.934-1.010)0.971 (0.934-1.010) | 0.9710.971 | 0.971(0.934-1.010)0.971 (0.934-1.010) | 0.9710.971 |
MaleMale | 1.888(0.447-7.973)1.888 (0.447-7.973) | 0.3870.387 | ||
AlcoholAlcohol | 1.000(0.995-1.005)1.000 (0.995-1.005) | 0.1730.173 | ||
Platelet countPlatelet count | 0.995(0.989-1.002)0.995 (0.989-1.002) | 0.0840.084 | -- | |
INRINR | 1.060(0.992-1.132)1.060 (0.992-1.132) | 0.7410.741 | ||
ASTAST | 1.000(0.998-1.001)1.000 (0.998-1.001) | 0.6200.620 | ||
ALTALT | 1.090(1.055-1.125)1.090 (1.055-1.125) | <0.001<0.001 | -- | |
BilirubinBilirubin | 0.461(0.206-1.034)0.461 (0.206-1.034) | 0.0600.060 | 0.619(0.264-1.453)0.619 (0.264-1.453) | 0.2710.271 |
AlbuminAlbumin | 0.461(0.206-1.034)0.461 (0.206-1.034) | 0.7750.775 | ||
GGTGGT | 1.182(0.898-1.555)1.182 (0.898-1.555) | 0.2330.233 | ||
CreatinineCreatinine | 0.938(0.883-0.996)0.938 (0.883-0.996) | 0.0380.038 | 0.961(0.901-1.024)0.961 (0.901-1.024) | 0.2180.218 |
SodiumSodium | 0.995(0.989-1.002)0.995 (0.989-1.002) | 0.1380.138 | ||
MELD scoreMELD score | 1.060(1.033-1.088)1.060 (1.033-1.088) | <0.001<0.001 | 1.049(1.019-1.080)1.049 (1.019-1.080) | 0.0010.001 |
(HR : Hazard ratio, Cl : Confidence interval)표2와 같이 콕스 회귀분석(Cox-regression analysis)을 통한 단변량 분석 결과를 살펴보면 빌리루빈(bilirubin) 농도, 혈장 나트륨(Sodium) 농도, MELD(Model for End-stage Liver Disease) score에 대한 정보가 유의한 Risk factor에 해당함을 알 수 있다.(HR: Hazard ratio, Cl: Confidence interval) Looking at the univariate analysis results through Cox-regression analysis as shown in Table 2, bilirubin concentration, plasma sodium concentration, MELD (Model for End) It can be seen that the information on the -stage Liver Disease) score corresponds to a significant risk factor.
또한, 표2와 같이 콕스 회귀분석(Cox-regression analysis)을 통한 다변량 분석 결과를 살펴보면 MELD(Model for End-stage Liver Disease) score에 대한 정보만이 유의한 Risk factor에 해당함을 알 수 있다.In addition, looking at the results of multivariate analysis through Cox-regression analysis as shown in Table 2, it can be seen that only information on the Model for End-stage Liver Disease (MELD) score corresponds to a significant risk factor.
다음으로, 검사 대상체의 전체 및 군별 각각의 혈청 시료로부터 MFG-E8 단백질의 농도값을 측정하였으며, 전체 및 군별 평균값을 산출하여 도3과 같은 결과를 얻었다.Next, the concentration value of the MFG-E8 protein was measured from the serum samples of all of the test subjects and each of the groups, and the average value of the total and each group was calculated to obtain a result as shown in FIG. 3.
여기서, 도3에 도시된 바와 같이 검사 대상체 전체의 혈청 시료 내 MFG-E8 단백질의 농도 평균값은 6.8±5.8 ng/mL이며, 중증 알코올성 간염 환자군의 혈청 시료 내 MFG-E8 단백질의 농도 평균값은 8.5±5.2 ng/mL이며, 나머지 대조군의 혈청 시료 내 MFG-E8 단백질의 농도 평균값은 5.8±5.9 ng/mL으로, 중증 알코올성 간염 환자군에서 대조군에 비해 유의한 높은 결과가 나타남을 알 수 있다.(P=0.007)Here, as shown in FIG. 3, the average concentration of MFG-E8 protein in the serum sample of the whole test subject is 6.8±5.8 ng/mL, and the average concentration of MFG-E8 protein in the serum sample of the severe alcoholic hepatitis patient group is 8.5± 5.2 ng/mL, and the average concentration of MFG-E8 protein in the serum samples of the rest of the control group was 5.8±5.9 ng/mL, indicating that the severe alcoholic hepatitis patient group showed significantly higher results than the control group (P = 0.007)
다음으로, 검사 대상체의 MFG-E8 단백질의 농도에 대한 피어슨 상관 분석(Pearson's correlation analysis) 및 다변량 선형 회귀분석(Multivariate linear Regression Analysis)을 수행하여 하기 표3과 같은 결과를 얻었다.Next, Pearson's correlation analysis and multivariate linear regression analysis were performed on the concentration of the MFG-E8 protein of the test subject to obtain the results shown in Table 3 below.
이와 같은 표3의 결과를 살펴보면, 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도는 빌리루빈(bilirubin) 농도, GGT(감마글루타밀전이효소, Gamma-glutamyltransferase) 농도, 혈장 나트륨(Sodium) 농도와 유의한 관련성을 보였다.Looking at the results in Table 3, the concentration of MFG-E8 protein in the serum sample of the test subject is significant with the concentration of bilirubin, GGT (gamma-glutamyltransferase), and plasma sodium. Showed a relevance.
또한, 표3에 도시된 바와 같이 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도는 다변량 선형 회귀분석 결과 빌리루빈(bilirubin) 농도 및 GGT(감마글루타밀전이효소, Gamma-glutamyltransferase) 농도와 유의한 관련성을 보임을 알 수 있다.In addition, as shown in Table 3, the concentration of MFG-E8 protein in the serum sample of the test subject was significantly related to the concentration of bilirubin and GGT (gamma-glutamyltransferase) as a result of multivariate linear regression analysis. Can be seen.
구체적으로, 도4에 도시된 바와 같이 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도와 빌리루빈(bilirubin) 농도의 상관관계(correlation)는 유의한 관련성을 보인다.Specifically, as shown in FIG. 4, the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin in a serum sample of a test subject shows a significant relationship.
아울러, 도5에 도시된 바와 같이 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도와 GGT(감마글루타밀전이효소, Gamma-glutamyltransferase) 농도의 상관관계(correlation)는 유의한 관련성을 보인다.In addition, as shown in FIG. 5, the correlation between the concentration of MFG-E8 protein in the serum sample of the test subject and the concentration of GGT (gamma-glutamyltransferase) shows a significant relationship.
이에 반해, 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도는 표3 및 도6에 도시된 바와 같은 MELD(Model for End-stage Liver Disease) score와의 상관관계(correlation)를 보이며, MFG-E8 단백질의 농도가 간 이식 또는 사망과 유의한 관련성을 보이지 않음을 나타낸다. (HR, 1.050; 95% CI, 0.987-1.116; P = 0.122)In contrast, the concentration of the MFG-E8 protein in the serum sample of the test subject showed a correlation with the Model for End-stage Liver Disease (MELD) score as shown in Table 3 and FIG. 6, and the MFG-E8 protein It indicates that the concentration of is not significantly associated with liver transplantation or death. (HR, 1.050; 95% CI, 0.987-1.116; P = 0.122)
Pearson's correlation coefficientPearson's correlation coefficient | PP | P*P* | |
AgeAge | -0.216-0.216 | 0.0090.009 | 0.3020.302 |
Platelet countPlatelet count | 0.0540.054 | 0.5200.520 | |
INRINR | -0.061-0.061 | 0.4680.468 | |
ASTAST | 0.0230.023 | 0.7850.785 | |
ALTALT | -0.005-0.005 | 0.9500.950 | |
BilirubinBilirubin | 0.4110.411 | <0.001<0.001 | <0.001<0.001 |
AlbuminAlbumin | 0.0470.047 | 0.5730.573 | |
GGTGGT | 0.4140.414 | <0.001<0.001 | <0.001<0.001 |
CreatinineCreatinine | -0.053-0.053 | 0.5250.525 | |
SodiumSodium | -0.164-0.164 | 0.0490.049 | 0.8100.810 |
MELD scoreMELD score | 0.2110.211 | 0.0110.011 |
(* : 다변량 선형 회귀분석(Multivariate linear Regression Analysis))더 나아가, 검사 대상체 전체에 대해 혈청 내 빌리루빈(bilirubin) 농도에 따른 세 군을 분류하여 아군 분석(Subgroup analysis)을 수행하였다.(*: Multivariate linear regression analysis) Furthermore, subgroup analysis was performed by classifying three groups according to the concentration of bilirubin in serum for the entire test subject.
여기서, 분류된 빌리루빈(bilirubin) 농도에 따른 세 군은 첫 번째로 Serum Bilirubin <2mg/dL인 군(n=32, 22.1%), 두 번째로 Serum Bilirubin ≥2mg/dL and <5mg/dL인 군(n=54, 37.3%), 세 번째로 Serum Bilirubin ≥5mg/dL인 군(n=59, 40.7%)이다.Here, the three groups according to the classified bilirubin concentration are the first group with Serum Bilirubin <2mg/dL (n=32, 22.1%), and the second group with Serum Bilirubin ≥2mg/dL and <5mg/dL. (n=54, 37.3%), and the third group was Serum Bilirubin ≥5mg/dL (n=59, 40.7%).
MFG-E8 단백질의 농도와 빌리루빈(bilirubin) 농도의 상관관계(correlation)에 대한 아군 분석(Subgroup analysis) 결과는 하기 표4에 도시된 바와 같다.The results of the subgroup analysis on the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin are shown in Table 4 below.
아울러, 표4에 도시된 바와 같이 Serum Bilirubin <2mg/dL인 군(n=32, 22.1%)에서만 MFG-E8 단백질의 농도와 빌리루빈(bilirubin) 농도의 상관관계(correlation)가 유의한 관련성을 보임을 알 수 있다.In addition, as shown in Table 4, only in the group with Serum Bilirubin <2mg/dL (n=32, 22.1%), the correlation between the concentration of MFG-E8 protein and the concentration of bilirubin showed a significant relationship. Can be seen.
Pearson's correlation coefficientPearson's correlation coefficient | PP | |
Bilirubin <2mg/dLBilirubin <2mg/dL | 0.4380.438 | <0.001<0.001 |
Bilirubin ≥2mg/dL and <5mg/dLBilirubin ≥2mg/dL and <5mg/dL | -0.041-0.041 | 0.7660.766 |
Bilirubin ≥5mg/dLBilirubin ≥5mg/dL | 0.1150.115 | 0.3880.388 |
이와 같은 결과들을 바탕으로 검사 대상체의 혈청 시료 내 MFG-E8 단백질의 농도는 검사 대상체의 혈청 시료 내 빌리루빈(bilirubin) 농도가 상승함에 따라 동반 상승함이 일반적이나 중증 알코올성 간염 환자에 해당하는 검사 대상체에서 이와 같은 상승 패턴이 나타나지 않게 되며, 이는 곧 중증 알코올성 간염의 예후와 관련된 것이라는 가설을 수립할 수 있다.이와 같은 가설의 검증을 위해 도7에 도시된 바와 같은 Serum Bilirubin <2mg/dL인 군(n=32, 22.1%)의 MFG-E8 단백질 농도와 빌리루빈(Bilirubin)의 농도 간의 상관관계(correlation) 결과를 바탕으로 빌리루빈(Bilirubin)의 농도 기반의 MFG-E8 기댓값(pMFG-E8 Level, Prediected MFG-E8 Level)에 대한 [수학식 1]을 도출하였다.Based on these results, the concentration of MFG-E8 protein in the serum sample of the test subject increases with the increase of the bilirubin concentration in the serum sample of the test subject. However, in the test subject corresponding to severe alcoholic hepatitis The hypothesis that such a rising pattern does not appear, which is soon related to the prognosis of severe alcoholic hepatitis, can be established. To verify this hypothesis, the group with Serum Bilirubin <2 mg/dL as shown in FIG. 7 (n =32, 22.1%) of MFG-E8 protein concentration and bilirubin concentration-based MFG-E8 expected value based on the concentration of bilirubin (pMFG-E8 Level, Prediected MFG-) [Equation 1] for E8 Level) was derived.
구체적으로, 이에 따른 [수학식 1]은 아래와 같다.Specifically, [Equation 1] according to this is as follows.
[수학식 1][Equation 1]
MFG-E8 기댓값(pMFG-E8 Level, Prediected MFG-E8 Level)=1.527+1.841×빌리루빈(Bilirubin)의 농도값(mg/dL)MFG-E8 Expected Value (pMFG-E8 Level, Prediected MFG-E8 Level) = 1.527+1.841×Bilirubin Concentration Value (mg/dL)
이와 같은 [수학식 1]을 이용해 산출한 MFG-E8 기대 농도(pMFG-E8)의 전체 및 군별(알코올성 간염 환자군(Pts with SAH) 및 나머지 대조군(Pts without SAH)) 평균값을 산출하여 도8과 같은 결과를 얻었다.The average value of the total and group (alcoholic hepatitis patient group (Pts with SAH) and the remaining control group (Pts without SAH)) of the expected MFG-E8 concentration (pMFG-E8) calculated using the above [Equation 1] was calculated, as shown in FIG. I got the same result.
구체적으로, 검사 대상체 전체에 대해 산출한 MFG-E8 기대 농도(pMFG-E8)의 평균값은 14.8±15.6 ng/mL이고, 도8에 도시된 바와 같이 알코올성 간염 환자군(Pts with SAH)에 대해 산출한 MFG-E8 기대 농도(pMFG-E8)의 평균값은 25.2±19.3 ng/mL이며, 나머지 대조군(Pts without SAH)에 대해 산출한 MFG-E8 기대 농도(pMFG-E8)의 평균값은 8.9±8.8 ng/mL로 알코올성 간염 환자군(Pts with SAH)에서 대조군에 비해 유의한 결과를 보이고 있다.Specifically, the average value of the expected MFG-E8 concentration (pMFG-E8) calculated for the entire test subject is 14.8±15.6 ng/mL, calculated for the alcoholic hepatitis patient group (Pts with SAH) as shown in FIG. The average value of the expected MFG-E8 concentration (pMFG-E8) is 25.2±19.3 ng/mL, and the average value of the expected MFG-E8 concentration (pMFG-E8) calculated for the remaining control group (Pts without SAH) is 8.9±8.8 ng/ In mL, the alcoholic hepatitis patient group (Pts with SAH) showed significant results compared to the control group.
더 나아가, 검사 대상체 전체에 대해 산출한 MFG-E8 기대 농도(pMFG-E8)와 검사 대상체 전체에 대해 검출한 MFG-E8 단백질의 농도(mMFG-E8) 간에는 도9에 도시된 바와 같은 상관관계(correlation)를 보이며, 이에 유의한 관련성이 있음을 알 수 있다.Furthermore, the correlation as shown in Fig. 9 between the expected concentration of MFG-E8 calculated for the entire subject (pMFG-E8) and the concentration of MFG-E8 protein detected for the entire subject (mMFG-E8) ( correlation), and it can be seen that there is a significant correlation.
이에 따라, 검출한 MFG-E8 단백질의 농도(mMFG-E8) 및 산출한 MFG-E8 기대 농도(pMFG-E8)를 이용하여 산출한 MFG-E8 기대 농도(pMFG-E8) 대비 검출한 MFG-E8 단백질의 농도(mMFG-E8)의 비율(ratio)를 계산하였고, 이에 대해 Cox regression analysis를 통한 단변량 분석 및 다변량 분석을 수행하였다.Accordingly, the detected MFG-E8 compared to the MFG-E8 expected concentration (pMFG-E8) calculated using the detected MFG-E8 protein concentration (mMFG-E8) and the calculated MFG-E8 expected concentration (pMFG-E8). The ratio of the protein concentration (mMFG-E8) was calculated, and univariate analysis and multivariate analysis through Cox regression analysis were performed.
그 결과, mMFG-E8/pMFG-E8 ratio는 간이식 또는 사망(HR, 0.125; 95% CI, 0.033-0.470; P = 0.002), MELD Score(HR, 1.060; 95% CI, 1.033-1.088; P<0.001)와 유의한 연관성을 보였다. 또한 다변량 분석 결과에서도 간이식 또는 사망(HR, 0.247; 95% CI, 0.064-0.959; P = 0.043), MELD Score(HR, 1.043; 95% CI, 1.012-1.076; P = 0.007)와 유의한 연관성을 보였다.As a result, the mMFG-E8/pMFG-E8 ratio was liver transplantation or death (HR, 0.125; 95% CI, 0.033-0.470; P = 0.002), MELD Score (HR, 1.060; 95% CI, 1.033-1.088; P <0.001) showed a significant association. In addition, the results of multivariate analysis were significantly associated with liver transplantation or death (HR, 0.247; 95% CI, 0.064-0.959; P = 0.043) and MELD Score (HR, 1.043; 95% CI, 1.012-1.076; P = 0.007). Showed.
더 나아가, 검사 대상체 그룹을 mMFG-E8/pMFG-E8 ratio에 따라 group 1(<0.3 mMFG-E8/pMFG-E8 ratio(n=32, 22.1%)), group 2(≥0.3 and <0.6 mMFG-E8/pMFG-E8 ratio(n=44, 30.3%)), group 3(≥0.6 and <0.9 mMFG-E8/pMFG-E8 ratio(n=28, 19.3%)) 및 group 4(>0.9 mMFG-E8/pMFG-E8 ratio(n=41, 28.3%))의 4개 군으로 분류하여 아군 분석(Subgroup analysis)을 수행하였다.Furthermore, according to the mMFG-E8/pMFG-E8 ratio, group 1 (<0.3 mMFG-E8/pMFG-E8 ratio (n=32, 22.1%)), group 2 (≥0.3 and <0.6 mMFG- E8/pMFG-E8 ratio (n=44, 30.3%)), group 3 (≥0.6 and <0.9 mMFG-E8/pMFG-E8 ratio (n=28, 19.3%)) and group 4 (>0.9 mMFG-E8) /pMFG-E8 ratio (n=41, 28.3%)) was classified into four groups, and a subgroup analysis was performed.
이에 따른, MFG-E8/pMFG-E8 ratio에 따라 분류된 4개의 각 군별 아군 분석(Subgroup analysis) 결과는 도10에 도시된 바와 같다.Accordingly, the results of subgroup analysis for each of the four groups classified according to the MFG-E8/pMFG-E8 ratio are as shown in FIG. 10.
마지막으로, MFG-E8/pMFG-E8 ratio에 따라 분류된 4개의 각 군별 LT-free survival rate를 분석 수행하였고, 이에 대한 결과는 도11에 도시된 바와 같다.Finally, the LT-free survival rates of each of the four groups classified according to the MFG-E8/pMFG-E8 ratio were analyzed, and the results are as shown in FIG. 11.
해당 결과, mMFG-E8/pMFG-E8 ratio <0.3인 group 1의 LT-free survival rate 가 유의하게 낮았으며(P=0.001), 1년 시점의 LT-free survival rate는 group 1 에서 53.3%, group 2에서 23%, group 3에서 16%, group 4에서 24%로 나타났다. As a result, the LT-free survival rate of group 1 with mMFG-E8/pMFG-E8 ratio <0.3 was significantly low (P=0.001), and the LT-free survival rate at 1 year was 53.3% in group 1, group It was 23% in 2, 16% in group 3, and 24% in group 4.
이와 같은 결과를 바탕으로 검사 대상체 그룹 내 중증 알코올성 간염 환자군을 mMFG-E8/pMFG-E8 ratio에 따라 group 1, <0.3 (n=22, 42.3%); group 2, ≥0.3 (n=30, 57.7%)의 두 군으로 분류하였으며 이들에 대한 각 군별 LT-free survival rate를 분석 수행하였고, 이에 대한 결과는 도12에 도시된 바와 같다.Based on these results, the group 1, <0.3 (n=22, 42.3%) of the group of severe alcoholic hepatitis patients in the test subject group according to the mMFG-E8/pMFG-E8 ratio; Group 2, ≥0.3 (n=30, 57.7%) were classified into two groups, and the LT-free survival rate for each group was analyzed, and the results are as shown in FIG.
구체적으로, 도12에 도시된 바와 같이 LT-free survival rate는 group 1에서 group 2 에 비해 유의하게 더 낮았고(P=0.019), 1 year LT-free survival rate는 group 1 에서 47.4%, group 2 에서 74.9% 로 나타났다. Specifically, as shown in Fig. 12, the LT-free survival rate was significantly lower in group 1 than in group 2 (P=0.019), and the 1-year LT-free survival rate was 47.4% in group 1, and in group 2. It was found to be 74.9%.
결론적으로, 혈청 MFG-E8은 담즙정체증(Cholestasis) 발생 시 그 정도에 따라 분비되어 항염증 기전 등을 통해 질환을 악화시키지만, 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)가 있을 때, 일부 환자에서는 MFG-E8 분비가 충분하지 않으며 그런 경우 불량한 예후를 보인다.In conclusion, serum MFG-E8 is secreted according to the degree of cholestasis and aggravates the disease through anti-inflammatory mechanisms. However, when severe alcoholic hepatitis (SAH) is present, in some patients The secretion of MFG-E8 is insufficient and in such cases a poor prognosis is shown.
따라서 혈청 내 MFG-E8 농도는 중증 알코올성 간염의 예후 예측에 중요한 바이오 마커임을 확인할 수 있었다.Therefore, it was confirmed that the concentration of MFG-E8 in the serum is an important biomarker in predicting the prognosis of severe alcoholic hepatitis.
본 발명에 개시된 실시예는 본 발명의 기술 사상을 한정하기 위한 것이 아니라 설명하기 위한 것이고, 이러한 실시예에 의해서 본 발명의 기술 사상의 범위가 한정되는 것은 아니다. 보호범위는 아래 청구범위에 의하여 해석되어야 하며, 그와 동등한 범위 내에 있는 모든 기술 사상은 본 발명의 권리 범위에 포함되는 것으로 해석되어야 할 것이다.The embodiments disclosed in the present invention are not intended to limit the technical idea of the present invention, but to explain it, and the scope of the technical idea of the present invention is not limited by these embodiments. The scope of protection should be interpreted by the following claims, and all technical ideas within the scope equivalent thereto should be interpreted as being included in the scope of the present invention.
Claims (3)
- 혈청 시료 내 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커로서 MFG-E8(Milk fat globule-EGF factor 8)를 검출하기 위한 제제를 포함하는 것을 특징으로 하는It comprises a preparation for detecting MFG-E8 (Milk fat globule-EGF factor 8) as a biomarker for predicting the prognosis of Severe Alcoholic Hepatitis (SAH) in a serum sample.중증 알코올성 간염 예후 예측용 조성물.A composition for predicting the prognosis of severe alcoholic hepatitis.
- 중증 알코올성 간염 예후 예측에 필요한 정보를 제공하기 위하여,To provide information necessary for predicting the prognosis of severe alcoholic hepatitis,검사 대상체 유래 혈청 시료로부터 중증 알코올성 간염(SAH, Severe Alcoholic Hepatitis)의 예후를 예측하기 위한 바이오 마커인 MFG-E8(Milk fat globule-EGF factor 8)의 농도를 검출하는 A단계;A step of detecting the concentration of MFG-E8 (Milk fat globule-EGF factor 8), a biomarker for predicting the prognosis of severe alcoholic hepatitis (SAH) from a serum sample derived from the test subject;상기 검사 대상체 유래 혈청 시료로부터 빌리루빈(Bilirubin)의 농도를 검출하는 B단계;B step of detecting the concentration of bilirubin from the serum sample derived from the test subject;상기 B단계를 통해 검출된 빌리루빈의 농도를 하기 수학식 1에 대입하여 MFG-E8 기댓값을 산출하는 C단계;Step C of calculating an expected MFG-E8 value by substituting the concentration of bilirubin detected in step B into Equation 1 below;상기 C단계를 통해 산출된 MFG-E8 기댓값 대비 상기 A단계를 통해 검출된 MFG-E8 농도값의 비율을 산출하는 D단계; 및 D step of calculating a ratio of the concentration value of MFG-E8 detected through the step A to the expected value of MFG-E8 calculated through the step C; And상기 D단계를 통해 산출된 MFG-E8 기댓값 대비 상기 검사 대상체 유래 혈청 시료 내 MFG-E8 농도값의 비율이 0.3 미만일 경우 상기 검사 대상체는 중증 알코올성 간염의 예후가 불량할 것으로 예측하는 E단계;를 포함하는 것을 특징으로 하는E step of predicting that the test subject will have a poor prognosis of severe alcoholic hepatitis when the ratio of the MFG-E8 concentration value in the serum sample derived from the test subject to the expected MFG-E8 value calculated through step D is less than 0.3; including; Characterized by중증 알코올성 간염 예후 예측용 바이오마커 검출 방법.Biomarker detection method for predicting the prognosis of severe alcoholic hepatitis.[수학식 1][Equation 1]MFG-E8 기댓값(pMFG-E8 Level, Prediected MFG-E8 Level)=1.527+1.841×빌리루빈(Bilirubin)의 농도값MFG-E8 Expected Value (pMFG-E8 Level, Prediected MFG-E8 Level) = 1.527+1.841×Bilirubin Concentration Value
- 제2항에 있어서,The method of claim 2,상기 B단계를 통해 검출된 빌리루빈의 농도 중 상기 C단계를 통해 MFG-E8 기댓값을 산출하기 위해 상기 수학식 1에 대입되는 빌리루빈의 농도는 2mg/dL 미만인 것을 특징으로 하는 Among the concentrations of bilirubin detected through step B, the concentration of bilirubin substituted in Equation 1 to calculate the expected value of MFG-E8 through step C is less than 2mg/dL.중증 알코올성 간염 예후 예측용 바이오마커 검출 방법.Biomarker detection method for predicting the prognosis of severe alcoholic hepatitis.
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