Link between plasma level of superoxide dismutase and patient prognosis in acute-on-chronic liver failure patients

By Samar Mahmoud, MS
Published February 10, 2022

Key Takeaways

  • This retrospective study found that plasma superoxide dismutase (SOD) levels can differentiate patients with acute-on-chronic liver failure (ACLF) into high-risk and low-risk groups.

  • The combination of SOD level and model for end-stage liver disease (MELD) score was a better predictor of patient outcomes than either value alone. 

  • Using a combination of SOD level and MELD score could be a useful prognostic tool that can be utilized to prioritize liver transplant candidates.

ACLF is characterized by a decline of liver function in patients with pre-existing chronic liver disease. Without liver transplantation, the mortality rate for ACLF patients is high.

Why This Study Matters 

Recent work has suggested that oxidative stress plays a critical role in liver failure. However, current scoring systems for evaluating severity and outcomes of ACLF have focused on impaired liver function. To date, there is limited data on the utility of a biomarker for oxidative stress in predicting disease severity and prognosis. To fill this gap, this study sought to determine if plasma SOD levels are predictive of disease severity in ACLF patients.

Study Design

This study included 124 participants. Healthy patients as well as patients with ACLF, liver cirrhosis, and acute liver failure (ALF) were included in the study. Plasma SOD levels were detected using an ELISA commercial kit. Investigators utilized the Kaplan–Meier method for survival analysis.

Results and Conclusions

Investigators found that patients with ACLF had significantly higher plasma SOD levels than healthy patients and patients with liver cirrhosis. However, there was not a statistically significant difference in plasma SOD levels between ACLF patients and ALF patients. A plasma SOD level > 428 U/mL was associated with a significant increase in the likelihood of death or liver transplantation in ACLF patients. The combination of plasma SOD levels and MELD score was superior to either method alone at predicting the severity and prognosis of ACLF patients. 

Related Research

Consider these findings from similar research studies:

  • Patients with acute liver failure have significantly increased SOD levels (Source). 

  • Plasma SOD level is a predictive tool for hepatitis E virus-induced-ACLF patient outcomes (Source).

Original Source 

Tian Z, Yao N, Wu Y, Wang F, Zhao Y. Association between plasma level of superoxide dismutase and survival of patients with acute-on-chronic liver failure. BMC Gastroenterol. 2022;22(1):50.

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