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. 2012;7(7):e40658.
doi: 10.1371/journal.pone.0040658. Epub 2012 Jul 13.

IgM-linked SerpinB3 and SerpinB4 in sera of patients with chronic liver disease

Alessandra Biasiolo  1 , Natascia Tono, Mariagrazia Ruvoletto, Santina Quarta, Cristian Turato, Gianmarco Villano, Luca Beneduce, Giorgio Fassina, Carlo Merkel, Angelo Gatta, Patrizia Pontisso
Affiliations

IgM-linked SerpinB3 and SerpinB4 in sera of patients with chronic liver disease

Alessandra Biasiolo et al. PLoS One. 2012.

Abstract

Background: Epidemiological studies indicate that a growing number of cirrhotic patients will develop hepatocellular carcinoma (HCC) in the next decade. Recent findings have demonstrated that Squamous cell carcinoma antigen 1 (SCCA1) and 2 (SCCA2) isoforms, now classified as serpinB3 and serpinB4, are over-expressed in HCC, but not in normal liver. As reported, high levels of circulating SCCA-IgM immunocomplexes in patients with cirrhosis are significantly associated with HCC development.

Aim: To ascertain whether IgM-linked SCCA isoforms circulate in patients with chronic liver disease, compared to total SCCA-IgM levels.

Methodology and findings: 79 patients with chronic liver disease were studied, including 17 patients with chronic hepatitis, 36 patients with cirrhosis and 26 with HCC. 28 blood donors were used as control. Monoclonal antibodies against serpinB3 and serpinB4 were used as catcher antibodies to set up specific ELISA assays, while total SCCA-IgM immunocomplexes were detected by commercially available ELISA assay. Overall, the results revealed a better diagnostic sensitivity of total SCCA-IgM assay, compared to both serpinB3 and serpinB4 IgM-linked assays. SerpinB4-IgM median values obtained with SCC103 antibody were moderately higher in patients with cirrhosis than in those with HCC, median values: 0.168 (IQR 0.140-0.427) vs. 0.140 (IQR 0.140-0.278), (p = 0.177). A trend toward decreasing serpinB4-IgM/serpinB3-IgM median ratio was observed in patients with advanced liver disease, being 1.08 in patients with HCC, 1.10 in patients with cirrhosis and 1.40 in patients with chronic hepatitis (p = 0.079).

Conclusions: IgM-linked SCCA isoforms in serum of patients with chronic liver diseases were quantified for the first time. Although the number of patients was limited, this preliminary study reveals that the relative balance of the two serpin isoforms is altered in HCC and it is characterized by a lower serpinB4-IgM/serpinB3-IgM ratio, determined by lower serpinB4 levels.

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Conflict of interest statement

Competing Interests: The authors have read the journal’s policy and have the following conflicts of interest to declare: LB and GF are employees of Xeptagen S.p.A. This does not alter the authors’ adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Serpin-IgM isoforms in cirrhotic patients with (panel A) and without (panel B) HCC evolution.
Data in the box-plot graphs represent median, upper and lower OD values for serpinB4-IgM (SCC 103), serpinB4-IgM (SCC 104) and serpinB3-IgM.
Figure 2
Figure 2. Distribution of serpinB4-IgM(SCC103)/serpinB3-IgM ratios.
Scatter plot displays the distribution of serpinB4-IgM(SCC103)/serpinB3-IgM ratios detected in patients with chronic hepatitis, cirrhosis and HCC. Horizontal bars represent median value for each group.
See this image and copyright information in PMC

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