Abstract

The Utility of STRIATIN as A Novel Diagnostic Marker in Cirrhosis

Aim: Endothelial dysfunction and associated endothelial Nitric Oxide Synthase (eNOS) mediated reduction in Nitric Oxide (NO) bioavailability has been implicated in the development of Portal Hypertension (PHT) in cirrhosis. However, the role of striatin, a key protein involved in the activation of the eNOS signaling pathway, remains largely unexplored in cirrhosis. Here, we aimed to study the hepatic expression of striatin and its connotation with eNOS in cirrhosis. Also, the systemic concentration of striatin in cirrhotic patients and to determine its potential as a diagnostic marker for cirrhotic patients with Portal Hypertension (PHT).

Materials and methods: This case-control study includes 40 cirrhotic patients and 40 healthy volunteers (control subjects). Hepatic striatin and phosphorylated eNOS (peNOS) expression were studied using western blotting. Systemic striatin and cyclic Guanosine Monophosphate (cGMP) levels were analyzed by ELISA and biochemical parameters were analysed using Beckman Coulter (AU 680) autoanalyzer.

Results: Systemic striatin concentration was markedly lower in cirrhotic patients compared to control subjects (6.86 ± 1.7 vs. 10.9 ± 1.7 ng/ml; P<0.0001). By contrast, systemic cGMP concentration was markedly increased in cirrhotic patients compared to control subjects (10.90 ± 2.8 vs. 5.19 ± 2.3 pmol/ml; P<0.0001), however, no association was observed between these parameters. Of note, decreased hepatic striatin protein expression observed in cirrhotic liver was positively associated with reduced peNOS expression. Moreover, Receiver Operator Characteristics (ROC) curve analysis shows that striatin had a better predictive diagnostic capability than cGMP in cirrhotic patients.

Conclusions: Our study shows evidence that systemic striatin levels and hepatic expression were markedly lowered in cirrhotic patients, and thus, it could be used as a possible potential diagnostic biomarker for liver cirrhotic patients with PHT. Indeed, our further study will pinpoint the therapeutic role of Striatin-eNOS-NO signaling in advanced cirrhosis.

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