CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure
Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is characterized by immune dysregulation and systemic inflammation, which lead to high mortality. Although immunosuppressive CD45+ erythroid progenitor cells (EPCs) percentages are elevated in chronic hepatitis B...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12876-025-03995-9 |
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| author | Nan Zhang Hai-Shi Wu Xiu-Qing Pang Cheng-You Yu Xing Li Zhi-Liang Gao |
| author_facet | Nan Zhang Hai-Shi Wu Xiu-Qing Pang Cheng-You Yu Xing Li Zhi-Liang Gao |
| author_sort | Nan Zhang |
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| description | Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is characterized by immune dysregulation and systemic inflammation, which lead to high mortality. Although immunosuppressive CD45+ erythroid progenitor cells (EPCs) percentages are elevated in chronic hepatitis B (CHB) and are associated with disease progression, their role in HBV-ACLF remains unclear. This study aims to evaluate the impact of CD45+ EPCs on disease progression in patients with HBV-ACLF. Methods In this retrospective study, we analyzed the data of 102 patients with CHB and 65 patients with HBV-ACLF receiving standard drugs treatment from the Third Affiliated Hospital of Sun Yat-sen University between January 2021 and December 2023. HBV-ACLF diagnosis followed the Chinese Group on the Study of Severe Hepatitis B–Acute-on-Chronic Liver Failure criteria, with strict exclusion of comorbidities. Peripheral blood mononuclear cells (PBMCs) were isolated via density gradient centrifugation, and CD45+ EPCs (CD45+ CD71+ CD235a+) were quantified using flow cytometry. Liver tissue EPCs were assessed by immunofluorescence in biopsy/transplant specimens. Receiver operating characteristic (ROC) and multivariable logistic regression analyses identified prognostic factors associated with disease progression. Results Our findings revealed that patients with HBV-ACLF had significantly elevated percentages of CD45+ EPCs compared with those with CHB. We also observed strong correlations between CD45+ EPC percentages and creatinine concentration, leukocyte count, and neutrophil-to-lymphocyte ratio (NLR). The area under the ROC curve for CD45+ EPCs was 0.718, indicating a significant predictive value [95% confidence interval (CI): 0.586–0.851, p = 0.004]. High CD45+ EPC percentage was associated with a greater incidence of hepatic encephalopathy (30.8% vs. 10.3%, p = 0.037) and higher rates of disease progression (73.1% vs. 35.9%, p = 0.003). Multivariate logistic regression analysis identified international normalized ratio (INR) and NLR as independent predictors of poor 28-day outcomes (INR odds ratio [OR] = 6.098, p < 0.001; NLR OR = 1.354, p = 0.005). Conclusions The percentage of CD45+ EPCs in PBMCs may be a potential biomarker for predicting 28-day disease progression in patients with HBV-ACLF. These findings highlight their possible clinical utility for risk stratification. |
| format | Article |
| id | doaj-art-902dc4f9f7974620a8fc05ed2f477b6b |
| institution | OA Journals |
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| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj-art-902dc4f9f7974620a8fc05ed2f477b6b2025-08-20T02:03:35ZengBMCBMC Gastroenterology1471-230X2025-05-0125111310.1186/s12876-025-03995-9CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failureNan Zhang0Hai-Shi Wu1Xiu-Qing Pang2Cheng-You Yu3Xing Li4Zhi-Liang Gao5Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen UniversityDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen UniversityDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen UniversityDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Key laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen UniversityDepartment of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen UniversityAbstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is characterized by immune dysregulation and systemic inflammation, which lead to high mortality. Although immunosuppressive CD45+ erythroid progenitor cells (EPCs) percentages are elevated in chronic hepatitis B (CHB) and are associated with disease progression, their role in HBV-ACLF remains unclear. This study aims to evaluate the impact of CD45+ EPCs on disease progression in patients with HBV-ACLF. Methods In this retrospective study, we analyzed the data of 102 patients with CHB and 65 patients with HBV-ACLF receiving standard drugs treatment from the Third Affiliated Hospital of Sun Yat-sen University between January 2021 and December 2023. HBV-ACLF diagnosis followed the Chinese Group on the Study of Severe Hepatitis B–Acute-on-Chronic Liver Failure criteria, with strict exclusion of comorbidities. Peripheral blood mononuclear cells (PBMCs) were isolated via density gradient centrifugation, and CD45+ EPCs (CD45+ CD71+ CD235a+) were quantified using flow cytometry. Liver tissue EPCs were assessed by immunofluorescence in biopsy/transplant specimens. Receiver operating characteristic (ROC) and multivariable logistic regression analyses identified prognostic factors associated with disease progression. Results Our findings revealed that patients with HBV-ACLF had significantly elevated percentages of CD45+ EPCs compared with those with CHB. We also observed strong correlations between CD45+ EPC percentages and creatinine concentration, leukocyte count, and neutrophil-to-lymphocyte ratio (NLR). The area under the ROC curve for CD45+ EPCs was 0.718, indicating a significant predictive value [95% confidence interval (CI): 0.586–0.851, p = 0.004]. High CD45+ EPC percentage was associated with a greater incidence of hepatic encephalopathy (30.8% vs. 10.3%, p = 0.037) and higher rates of disease progression (73.1% vs. 35.9%, p = 0.003). Multivariate logistic regression analysis identified international normalized ratio (INR) and NLR as independent predictors of poor 28-day outcomes (INR odds ratio [OR] = 6.098, p < 0.001; NLR OR = 1.354, p = 0.005). Conclusions The percentage of CD45+ EPCs in PBMCs may be a potential biomarker for predicting 28-day disease progression in patients with HBV-ACLF. These findings highlight their possible clinical utility for risk stratification.https://doi.org/10.1186/s12876-025-03995-9Acute-on-chronic liver failureCD45+ erythroid progenitor cellsLogistic regressionBiomarkerDisease progression |
| spellingShingle | Nan Zhang Hai-Shi Wu Xiu-Qing Pang Cheng-You Yu Xing Li Zhi-Liang Gao CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure BMC Gastroenterology Acute-on-chronic liver failure CD45+ erythroid progenitor cells Logistic regression Biomarker Disease progression |
| title | CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure |
| title_full | CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure |
| title_fullStr | CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure |
| title_full_unstemmed | CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure |
| title_short | CD45+ erythroid progenitor cells as potential biomarkers for disease progression in hepatitis B virus-related acute-on-chronic liver failure |
| title_sort | cd45 erythroid progenitor cells as potential biomarkers for disease progression in hepatitis b virus related acute on chronic liver failure |
| topic | Acute-on-chronic liver failure CD45+ erythroid progenitor cells Logistic regression Biomarker Disease progression |
| url | https://doi.org/10.1186/s12876-025-03995-9 |
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