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Researchers assert WFA–plus-M2BP useful biomarker for PBC

Wisteria floribunda agglutinin-positive Mac-2-binding protein serum level was found to be an accurate biomarker in predicting liver fibrosis and determining prognosis of primary biliary cirrhosis, according to new data published in the American Journal of Gastroenterology.

“The [Wisteria floribunda agglutinin-positive mac-2-binding protein] method has been validated for chronic hepatitis C and nonalcoholic fatty liver disease, and may also predict the development of hepatocellular carcinoma,” the researchers wrote. “However, its ability to reflect extensive fibrosis and prognosis in [primary biliary cirrhosis] remains to be demonstrated. The objective of this study was to assess the diagnostic performance of the [Wisteria floribunda agglutinin-positive Mac-2-binding protein assay] for the evaluation for fibrosis and long-term clinical outcome in [primary biliary cirrhosis].”

Researchers, including Takeji Umemura, MD, PhD, department of medicine, Shinshu University School of Medicine, Matsumoto, Japan, and colleagues, analyzed data of 137 Japanese patients with primary biliary cirrhosis (PBC) who underwent liver biopsy and various serological tests for Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA⁺-M2BP). All patients were treated with 10 to 13 mg/kg of ursodeoxycholic acid per day. Forty-five healthy patients with normal liver function tests served as controls. In addition, 40 patients with type 1 autoimmune hepatitis were included and used as comparison to patients having another autoimmune liver disease, according to the research. Clinical data from WFA⁺-M2BP were compared with data from other noninvasive markers, such as Forn’s index, Mayo score and others.

In the patients with PBC, median serum WFA⁺-M2BP increased as fibrosis progressed, indicating that WFA⁺-M2BP was independently associated with liver fibrosis stage. The cutoff values of WFA⁺-M2BP was 0.7 for fibrosis stage ≥ F1, 1 for ≥ F2, 1.4 for ≥ F3 and 2 for F4.

The area under the receiver operating characteristic curve (AUC) value for significant fibrosis was 0.979, 0.933 for severe fibrosis and 0.965 for cirrhosis, according to the research. The AUC of WFA⁺-M2BP for predicting fibrosis was superior to Fibrosis-4 index, aspartate transaminase-platelet ratio index, aspartate aminotransferase/alanine aminotransferase ratio, Forn’s Index and Mayo Score (P < .001 for all). WFA⁺-M2BP serum level at baseline was found to be independently associated with clinical outcome (HR = 18.59; P = .021).

“WFA⁺-M2BP appears to be a simple, reliable and noninvasive method for evaluating fibrosis and predicting clinical outcome in PBC,” the researchers concluded. – by Melinda Stevens

Disclosures: Umemura reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.