Serum thymosin β4 levels in patients with hepatitis B virus-related liver failure

RESULTS: Compared with healthy controls, serum thymosin β4 levels in ACLF, CLF, CR and chronic hepatitis B patients were significantly lower, 6.5047 (4.7879-10.5314) μg/mL vs 0.4632 (0.2759-0.8768) μg/mL, 0.6981 (0.5209-1.2008) μg/mL, 1.8053 (0.8110-2.3397) μg/mL, 3.7803 (1.8570-6.4722) μg/mL, respectively (P < 0.001). The levels of thymosin β4 in liver failure (ACLF or CLF) patients were markedly lower than that in CR (P < 0.001), and a difference was also found between CLF and ACLF patients (P = 0.038). In patients with chronic liver disease, there was a positive relationship between thymosin β4 levels and albumin, choline esterase, and platelet (P < 0.001), and negative relationship with alanine aminotransferase (P = 0.020), aspartate aminotransferase, total bilirubin, international normalized ratio of prothrombin time, and Child-Pugh and MELD scores (P < 0.001). Of the 61 liver failure patients, the thymosin β4 levels of non-survivors were significantly lower than that of survivors ( P = 0.007). Receiver operating characteristics analysis identified a thymosin β4 cutoff level of 0.5708 μg/mL for predicting poor prognosis in all liver failure patients. The serial thymosin β4 values were observed in 13 liver failure inpatients. Lower initial values were observed in the death. While greater improvement in thymosin β4 value was found in those who recovered from the disease.