Serum type III procollagen peptide and laminin (Lam-P1) detect alcoholic hepatitis in chronic alcohol abusers

The diagnosis of alcoholic hepatitis is difficult to establish by conventional clinical and laboratory methods, and a firm diagnosis relies on liver histology. Since there are severe limitations in following patients with repeated liver biopsies, noninvasive procedures are needed to assess the presence of alcoholic hepatitis in chronic alcohol abusers. It has been suggested that serum Type III procollagen peptide levels correlates with the degree of inflammation in chronic liver disease. Since inflammation is a major histological finding in alcoholic hepatitis, we therefore studied the usefulness of measuring serum Type III procollagen peptide and laminin values in 45 consecutive chronic alcohol abusers, with or without cirrhosis, in detecting those with alcoholic hepatitis. The results showed that both Type III procollagen peptide and laminin values were elevated in all of the patients with established liver damage. However, the values were highest in those with liver cirrhosis plus alcoholic hepatitis (Type III procollagen peptide 50.4 ± 36.4 ng per ml vs. 8.1 ± 2.6 in controls, p < 0.01; laminin 4.50 ± 1.49 units per liter vs. 1.24 ± 0.26 units per liter in controls, p < 0.01), followed by subjects with alcoholic hepatitis alone (Type III procollagen peptide 23.5 ± 17.6 ng per ml, p < 0.01; laminin 2.60 ± 1.09 units per liter, p < 0.01). Whereas Type III procollagen peptide values did not discriminate among patients with cirrhosis (21.5 ± 10.1 ng per ml) and those with steatofibrosis (14.3 ± 3.2 ng per ml), nor among those with alcoholic hepatitis and those with steatofibrosis, laminin values did (respectively, 2.12 ± 0.60 units per liter and 1.42 ± 0.41 units per liter, p < 0.01). We thus suggest that independently of whether Type III procollagen peptide or laminin serum values reflect increased deposition or breakdown of extracellular matrix components, they are useful in recognizing alcoholic hepatitis patients.