Background: Caspase-1 is an evolutionarily conserved enzyme that proteolytically cleaves the precursors of the\ninflammatory cytokines interleukin 1Beta and interleukin 18. However, the role of caspase-1 in determining the severity\nof acute-on-chronic liver failure (ACLF) has yet to be elucidated. We evaluated the expression levels of caspase-1 in\nHBV-related liver disease and assessed its utility as a biomarker predicting the severity of ACLF.\nMethods: The gene, protein and activity levels of caspase-1 were measured in the liver and/or serum of subjects\nwith HBV-related disease. We also analysed the correlation between the expression levels of caspase-1 and liver\ninjury of ACLF.\nResults: Compared with the values observed in normal subjects, the relative caspase-1 mRNA and protein levels in\nlivers were decreased in patients with CHB, LC, and HCC but increased in those with ACLF; moreover, ACLF patients\nhad the lowest serum level and hepatic activity of caspase-1 among the five groups. The serum caspase-1 levels in\nACLF patients showed a negative correlation with total serum bilirubin and a positive correlation with serum total\nprotein and albumin. Importantly, the serum caspase-1 levels in the surviving group with ACLF were higher than\nthose in the non-surviving group and showed different dynamic trends. Analyses of the area under the receiver\noperating characteristic curve indicated that caspase-1 (AUC = 0.84, AUC of MELD score = 0.72) may be a useful\nmarker for independently predicting ACLF.
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