Acute-on-Chronic Liver Failure and Serum Nitric Oxide Levels

Acute-on-chronic liver failure (ACLF) patients may be classified as high-risk or low-risk based on serum nitric oxide (NO) levels at the time of hospitalization, says an article published in the International Journal of General Medicine.

Acute-on-chronic liver failure is described as acute worsening of liver function in chronic liver disease patients, and it is associated with multiorgan failure and high short-term death rates. Fewer than half of individuals with acute-on-chronic liver failure recover spontaneously, and ACLF is linked with a significant mortality rate in the absence of liver transplantation. Nitric oxide is involved in the pathophysiology of a number of liver illnesses. As a result, Fei Wang and colleagues undertook this investigation to see if blood NO levels might be utilized as a biomarker to predict the severity and prognosis of ACLF patients.

For this study, a retrospective cohort of 120 ACLF patients, as well as normal and cirrhotic controls, was studied between January 2018 and September 2020. A commercial ELISA kit was used to quantify blood NO levels, and a Kaplan-Meier survival analysis was performed.

Key Findings

• Serum NO levels in ACLF patients were substantially greater than in normal and cirrhotic controls.
• The blood NO level, as well as the Model for End-stage Liver Disease (MELD) score, were found to be an inexpensive, easily accessible, and substantial independent predictor of mortality in multivariate analysis.
• A blood NO level of more than 53.5 mol/L was related to a substantial increase in the probability of death or liver transplantation in ACLF patients.
• To determine the severity and prognosis of ACLF patients, a combination of serum NO level and MELD score performed better.

In conclusion, the current study found that (1) ACLF patients have higher blood NO levels, and (2) serum NO levels along with the MELD score are a valid predictor of ACLF outcomes.

Reference

Wang, F., Tai, M., He, Y., & Tian, Z. (2022). Serum Nitric Oxide Level Serves as a Potential Prognostic Biomarker in ACLF Patients. In International Journal of General Medicine: Vol. Volume 15 (pp. 6713–6723). Informa UK Limited. https://doi.org/10.2147/ijgm.s379837