ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Keratin 18 Is a Diagnostic and Prognostic Factor for Acute Alcoholic Hepatitis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Double-blind Randomized Controlled Trial of Anakinra, Pentoxifylline, and Zinc Compared to Methylprednisolone in Severe Acute Alcoholic Hepatitis
Novel Therapies in Moderately Severe Acute Alcoholic Hepatitis
Lactobacillus Rhamnosus GG: A Novel Probiotic Therapy for Treating Alcohol Use Disorder
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Serum Cytokeratin-18 levels as a prognostic biomarker in advanced liver disease: a comprehensive meta-analysis.Clinical and experimental medicine · 2024Pooled it
- Trial
- Hepatoprotective effects of resolvin D1 in mice exposed to ethanol and galactosamine.Hepatology communications · 2026Article
- Sparse CCA-based mediation analysis with high-dimensional exposures and mediators.Bioinformatics (Oxford, England) · 2026Article
- Regulated necrosis at the crossroads of liver inflammation and cancer development.Nature reviews. Gastroenterology & hepatology · 2026Review
- Regulation of Keratin Chemical Modifications: Potential Molecular Mechanisms in Proliferative Diseases.International journal of molecular sciences · 2026Review
- Illustration of the gut-immune-liver axis in early-stage alcohol-related liver disease: role and non-invasive potentiation of biomarkers and peptidomic signatures.Npj gut and liver · 2026Article
- GDF15 is associated with hepatocellular senescence and correlates with mortality in patients with alcohol-associated hepatitis.JHEP reports : innovation in hepatology · 2025Article
- Chronic and Heavy Drinking, Nutrition Status, and Progression of Liver Injury Negatively Affect the Mortality Risk in Patients Suffering from Alcohol-Associated Hepatitis.Journal of clinical medicine · 2025Article
- Recompensation of Liver Cirrhosis by TIPS Reduces Epithelial Cell Death Markers, Translating Into Improved Clinical Outcome.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Acute alcohol-associated hepatitis: Latest findings in non-invasive biomarkers and treatment.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Non-Invasive Biomarkers for Differentiating Alcohol Associated Hepatitis from Acute Decompensation in Patients with ALD.Journal of clinical medicine · 2024Review
- Serum/Plasma Proteome in Non-Malignant Liver Disease.International journal of molecular sciences · 2024Review
- Human Precision-Cut Liver Slices: A Potential Platform to Study Alcohol-Related Liver Disease.International journal of molecular sciences · 2023Article
- Assessing Platelet Mitochondrial Dysfunction in a Murine Model of Acute Acetaminophen Toxicity.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2023Article
- New murine model of alcoholic hepatitis in obesity-induced metabolic-associated fatty liver disease.Experimental animals · 2023Article
- Serum keratin 18-M65 levels detect progressive forms of alcohol-associated liver disease in early noncirrhotic stages.Alcohol, clinical & experimental research · 2023Article
- Characterization of Hypomagnesemia in Alcoholic Hepatitis Patients and Its Association with Liver Injury and Severity Markers.Journal of clinical medicine · 2023Article
- Metabolomics analysis of urine from patients with alcohol-associated liver disease reveals dysregulated caffeine metabolism.American journal of physiology. Gastrointestinal and liver physiology · 2023Article
- Recent Advances in Understanding of Pathogenesis of Alcohol-Associated Liver Disease.Annual review of pathology · 2023Review
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsAcute alcoholic hepatitis (AAH) is a major cause of liver-related morbidity and mortality; there are no good blood biomarkers for diagnosis or determining magnitude of cell death. Keratin 18 (KRT18, also called K18), found in epithelial cells, is released from hepatocytes upon death. We investigated whether level of K18 is a better marker of hepatocyte death than standard biomarkers and might be used to identify patients with AAH at risk for death within 90 days.
methodsWe analyzed data from 173 participants in a large trial performed at 4 medical centers. Participants with AAH were classified as severe (n = 57, model for end-stage liver disease [MELD] scores above 20) or moderate (n = 27, MELD scores from 12 to 19); 38 participants had alcohol use disorder with mild (n = 28) or no liver injury (n = 10); 34 participants had nonalcoholic steatohepatitis; and 17 participants were healthy (controls). We quantified serum levels of K18 using ELISAs and APOPTOSENSE kits.
resultsSerum level of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the ratio of AST:ALT did not correlate with MELD scores. Patients with alcohol use disorder had higher serum levels of ALT than patients with severe AAH. Levels of K18M65 and K18M30 had statistically significant increases as liver disease worsened, as did the degree of necrosis (ratio of K18 M65:M30). The ratio of K18M65:ALT was increased in serum from patients with AAH compared with controls. Serum levels of K18 identified patients who died within 90 days with greater accuracy than commonly used static biomarkers.
conclusionsThere is a stronger association between serum level of keratin 18 and amount of hepatocyte death and liver disease severity than for other biomarkers (AST, ALT, and the AST:ALT ratio). The ratio of K18M65:M30 might be used as marker of mechanism of hepatocyte death, and the ratio of K18M65:ALT might be used to distinguish patients with AAH from patients with nonalcoholic steatohepatitis. Serum levels of K18 might be used to identify patients with severe AAH at risk for death. ClinicalTrials.gov identifier # NCT01922895 and NCT01809132.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.