Prediction of severity for acute liver damage by three-dimensional quantitative analysis of asialoglycoprotein receptor activity

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K16472
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Osaka City University
• Principal Investigator: KOTANI KOHEI 大阪市立大学, 大学院医学研究科, 病院講師 (50711793)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: アシアロ糖蛋白受容体 / SPECT/CT / 定量解析 / 急性肝障害 / 肝予備能 / Tc-99m-GSA / 肝線維化 / 肝炎

Outline of Final Research Achievements

To search for a model that predicts the severity and prognosis of acute liver damage early in onset, three-dimentional quantitative analysis of asialoglycoprotein receptor activity by asialoscintigraphy using SPECT/CT was performed within the first 3 weeks after the onset. Among many factors, gamma-GTP, MELD score, LHL15 and liver uptake count (LUC) showed significant factors contributing to the progression to acute liver failure in the univariate analysis, but no independent factor was found in the multivariate analysis. On the other hand, prothrombin time, LHL15 and LUC showed significant factors contributing to the days of hospitalization in the single linear regression analysis, and LHL15 was identified as a significant factor in multiple linear regression analysis (p=0.018). Quantitative analysis of asialoglycoprotein receptor activity is useful for assessing the disease condition in the early stage of acute liver damage.

Free Research Field

消化器核医学

Academic Significance and Societal Importance of the Research Achievements

急性肝障害では肝予備能および予後評価の指標として、Model for End-stage Liver Disease(MELD score)や難治性肝胆道疾患に関する研究班による肝移植適応ガイドラインが用いられるが、重症化、とくに劇症化した症例では有用である一方で、肝機能が低下傾向だが急性肝不全までには至っていない初期の段階での診断能は高くない。肝細胞のアシアロ糖蛋白受容体活性の2次元および3次元定量解析により発症初期の急性肝障害の重症度と予後との関連を詳細に調査した検討はなく、本研究結果が急性肝障害診療の一助になれば、肝不全の抑止につながり社会的に貢献できる可能性がある。