Posttranscriptional changes of serum albumin: Clinical and prognostic significance in hospitalized patients with cirrhosis

• DOI: 10.1002/hep.27322
• Publication Date: 2014-07-21T16:14:51Z
• Authors: Marco Domenicali; Maurizio Baldassarre; Ferdinando A Gian...; Marina Naldi; Marianna Mastroro...; Maurizio Biselli; Maristella Laggetta; Daniela Patrono; Carlo Bertucci; Mauro Bernardi; Paolo Caraceni
• Keywords: Human serum albumin; Serum Albumin; Pathophysiology; Liver disease

Beside the regulation of fluid distribution, human serum albumin (HSA) carries other activities, such as binding, transport, and detoxification many molecules. In patients with cirrhosis, HSA exhibits posttranscriptional alterations that likely affect its functions. This study aimed at identifying structural occurring in cirrhosis determining their relationship specific clinical complications patient survival. One hundred sixty-eight 35 stable conditions 133 hospitalized for acute complications, 94 healthy controls were enrolled. Posttranscriptional molecular changes identified quantified by using a high-performance liquid chromatography/electrospray ionization mass spectrometry technique. Clinical biochemical parameters also recorded followed up to 1 year. Seven isoforms carrying one or more identified. Altered significantly represented than controls. Conversely, native, unchanged isoform was reduced cirrhosis. Native most altered correlated both Child-Pugh Model End-Stage Liver Disease scores. patients, oxidized N-terminal truncated independently associated ascites, renal impairment, bacterial infection. Finally, native cysteinylated/N-terminal predictors 1-year survival, greater prognostic accuracy total concentration. Conclusions: Extensive HSA, involving several sites increasing parallel disease severity, occur are whereas residual, predicts These findings support concept "effective concentration," which implies global function is related not only concentration, but preservation integrity. (Hepatology 2014;60:1850–1859)