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Noninvasive diagnosis of liver cirrhosis using DNA sequencer–based total serum protein glycomics

Abstract

We applied our 'clinical glycomics' technology, based on DNA sequencer/fragment analyzers, to generate profiles of serum protein N-glycans of liver disease patients. This technology yielded a biomarker that distinguished compensated cirrhotic from noncirrhotic chronic liver disease patients, with 79% sensitivity and 86% specificity (100% sensitivity and specificity for decompensated cirrhosis). In combination with the clinical chemistry–based Fibrotest biomarker, compensated cirrhosis was detected with 100% specificity and 75% sensitivity. The current 'gold standard' for liver cirrhosis detection is an invasive, costly, often painful liver biopsy. Consequently, the highly specific set of biomarkers presented could obviate biopsy in many cirrhosis patients. This biomarker combination could eventually be used in follow-up examinations of chronic liver disease patients, to yield a warning that cirrhosis has developed and that the risk of complications (such as hepatocellular carcinoma) has increased considerably. Our clinical glycomics technique can easily be implemented in existing molecular diagnostics laboratories.

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Figure 1: Examples of total serum protein N-glycan profiles.
Figure 2: Trends in derived diagnostic variables.
Figure 3: Classification efficiency.
Figure 4: Values of some glycome markers gradually increase with fibrosis stage.
Figure 5: Partial structural analysis of differentially regulated N-glycans.

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References

  1. Staudt, L.M. Molecular diagnosis of the hematologic cancers. N. Engl. J. Med. 348, 1777–1785 (2003).

    Article  CAS  Google Scholar 

  2. Wulfkuhle, J.D., Liotta, L.A. & Petricoin, E.F. Proteomic applications for the early detection of cancer. Nat. Rev. Cancer 3, 267–275 (2003).

    Article  CAS  Google Scholar 

  3. Hanash, S. Disease proteomics. Nature 422, 226–232 (2003).

    Article  CAS  Google Scholar 

  4. Brindle, J.T. et al. Rapid and noninvasive diagnosis of the presence and severity of coronary heart disease using 1H-NMR-based metabonomics. Nat. Med. 8, 1439–1444 (2002).

    Article  CAS  Google Scholar 

  5. Callewaert, N., Geysens, S., Molemans, F. & Contreras, R. Ultrasensitive profiling and sequencing of N-linked oligosaccharides using standard DNA-sequencing equipment. Glycobiology 11, 275–281 (2001).

    Article  CAS  Google Scholar 

  6. Ashwell, G. & Harford, J. Carbohydrate-specific receptors of the liver. Annu. Rev. Biochem. 51, 531–554 (1982).

    Article  CAS  Google Scholar 

  7. Lee, S.J. et al. Mannose receptor-mediated regulation of serum glycoprotein homeostasis. Science 295, 1898–1901 (2002).

    Article  CAS  Google Scholar 

  8. Cadranel, J.F., Rufat, P. & Degos, F. Practices of liver biopsy in France: results of a prospective nationwide survey. Hepatology 32, 477–481 (2000).

    Article  CAS  Google Scholar 

  9. Menon, K.V. & Kamath, P.S. Managing the complications of cirrhosis. Mayo Clin. Proc. 75, 501–509 (2000).

    Article  CAS  Google Scholar 

  10. Kuper, H. et al. The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis. Hepatology 34, 714–718 (2001).

    Article  CAS  Google Scholar 

  11. Piccinino, F., Sagnelli, E., Pasquale, G. & Giusti, G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J. Hepatol. 2, 165–173 (1986).

    Article  CAS  Google Scholar 

  12. Imbert-Bismut, F. et al. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet 357, 1069–1075 (2001).

    Article  CAS  Google Scholar 

  13. Poynard, T. et al. Biochemical markers of liver fibrosis in patients infected by hepatitis C virus: longitudinal validation in a randomized trial. J. Viral. Hepat. 9, 128–133 (2002).

    Article  CAS  Google Scholar 

  14. Henderson, A.R. Assessing test accuracy and its clinical consequences: a primer for receiver operating characteristic curve analysis. Ann. Clin. Biochem. 30, 521–539 (1993).

    Article  Google Scholar 

  15. The METAVIR cooperative group. Inter- and intra-observer variation in the assessment of liver biopsy of chronic hepatitis C. Hepatology 20, 15–20 (1994).

  16. Bellentani, S. et al. Prevalence of chronic liver disease in the general population of northern Italy: the Dionysos study. Hepatology 20, 1442–1449 (1994).

    Article  CAS  Google Scholar 

  17. Parekh, R.B. et al. Association of rheumatoid arthritis and primary osteoarthritis with changes in the glycosylation pattern of total serum IgG. Nature 316, 452–457 (1985).

    Article  CAS  Google Scholar 

  18. Stibler, H. Carbohydrate-deficient transferrin in serum: a new marker of potentially harmful alcohol consumption reviewed. Clin. Chem. 37, 2029–2037 (1991).

    CAS  Google Scholar 

  19. Miyoshi, E. et al. Gene expression of N-acetylglucosaminyltransferases III and V: a possible implication for liver regeneration. Hepatology 22, 1847–1855 (1995).

    CAS  Google Scholar 

  20. Ishibashi, K. et al. N-Acetylglucosaminyltransferase-III in human serum, and liver and hepatoma tissues — increased activity in liver cirrhosis and hepatoma patients. Clin. Chim. Acta 185, 325–332 (1989).

    Article  CAS  Google Scholar 

  21. Sawamura, T. et al. Hyperasialoglycoproteinemia in patients with chronic liver diseases and/or liver cell carcinoma. Asialoglycoprotein receptor in cirrhosis and liver cell carcinoma. Gastroenterology 87, 1217–1221 (1984).

    CAS  Google Scholar 

  22. Ise, H., Sugihara, N., Negishi, N., Nikaido, T. & Akaike, T. Low asialoglycoprotein receptor expression as markers for highly proliferative potential hepatocytes. Biochem. Biophys. Res. Commun. 285, 172–182 (2001).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

N.C. is a postdoctoral fellow with the Fund for Scientific Research Flanders. This work was supported by the Fund for Scientific Research Flanders and by Ghent University (GOA Grant 12052299). The authors thank all blood donors for their participation; B. Vandekerckhove of the Blood Transfusion Center of the Red Cross Ghent and F. Dekeyser of the Department of Internal Medicine of Ghent University hospital for their collaboration; A. Vandeputte for expert technical assistance; A. Bredan for manuscript editing; B. Wuyts and J. Penders for assistance; M. Aebi for making an ABI 310 available for some of our experiments; and the management and technology transfer team of the Flanders Interuniversity Institute for Biotechnology for their encouragement.

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Correspondence to Nico Callewaert or Roland Contreras.

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There is a patent application (WO 03/087833) connected to this work.

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Callewaert, N., Vlierberghe, H., Hecke, A. et al. Noninvasive diagnosis of liver cirrhosis using DNA sequencer–based total serum protein glycomics. Nat Med 10, 429–434 (2004). https://doi.org/10.1038/nm1006

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