ObjectiveTo investigate the correlation of miR-181c expression in peripheral blood mononuclear cells (PBMCs) with interferon-γ (IFN-γ), chemokine (C-X-C motif) ligand 10 (CXCL10), and Toll-like receptor 4 (TLR4) in children with autoimmune hepatitis (AIH). MethodsA total of 27 children with AIH who were admitted to The Affiliated Hospital of Yanbian University from March 2015 to May 2019 were enrolled as AIH group, and 30 healthy children who underwent physical examination during the same period of were enrolled as control group. The expression of miR-181c in PBMCs and the expression of IFN-γ, CXCL10, and TLR4 were measured for the two groups. The t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Pearson correlation coefficient was used to investigate the correlation of miR-181c expression with each index, and a logistic regression analysis was used to investigate the influence of each factor on AIH. ResultsCompared with the control group, the AIH group had significantly higher levels of the liver function parameters aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and total bilirubin (TBil) (t=14.445,20.064，11.728,13.822, all P＜0.001). The AIH group also had significantly higher levels of IgA, IgM, and IgG than the control group (t=7.772, 5147, and 6771, all P＜0.05). The AIH group had significantly lower relative expression of miR-181c in PBMCs than the control group (0.784±0173 vs 1.106±0.224, t=5.819, P＜0.05). Compared with the control group, the AIH group had significantly higher levels of IFN-γ and CXCL10 and mRNA expression of TLR4 (t=6.949, 12.303, and 13.835, all P＜0.05). The correlation analysis showed that in the children with AIH, the expression of miR-181c in PBMCs was negatively correlated with IFN-γ, CXCL10, TLR4, AST, ALT, GGT, TBil, and IgG (r=-0.316, -0.348, -0.322, -0.427, -0.442, -0.408, -0.396, and -0.321, all P＜0.05). The univariate logistic regression analysis showed that AST, ALT, GGT, TBil, IFN-γ, CXCL10, TLR4 mRNA, and miR-181c were all included in the regression model (all P＜0.05) and were the influencing factors for the onset of AIH. ConclusionChildren with AIH have downregulated expression of miR-181c in PBMCs, which is closely associated with IFN-γ, CXCL10, and TLR4, suggesting that miR-181c may affect the development of AIH in children by regulating the immune system.

ObjectiveTo investigate the value of intestinal fatty acid binding protein （I-FABP） in predicting the development and progression of acute-on-chronic liver failure （ACLF）. MethodsA retrospective analysis was performed for the clinical data of 168 patients with decompensated liver cirrhosis who were admitted to The Affiliated Hospital of Yanbian University from September 2020 to March 2023. The conditions of the patients with ACLF on admission were observed， and the patients were followed up for 6 months to identify new-onset ACLF cases. ELISA was used to measure the serum level of I-FABP on admission. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H rank sum test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between groups； the Jonckheere-Terpstra test was used for trend analysis. The Spearman correlation analysis was used to investigate the correlation between two variables， and the multivariate Cox regression analysis was used to investigate the influencing factors for new-onset ACLF during follow-up. The Kaplan-Meier curve was used to analyze the onset of ACLF in different groups， and the log-rank test was used for the analysis of such differences. The receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC） were used to investigate the performance of I-FABP in predicting the development and progression of ACLF. ResultsAmong the 168 patients enrolled in this study， there were 43 patients with ACLF and 125 patients without ACLF， among whom 19 developed ACLF during follow-up. The patients with ACLF on admission had a significantly higher level of I-FABP than those without ACLF （Z=4.359， P<0.001）. The patients with new-onset ACLF had a significantly higher level of I-FABP than those without new-onset ACLF （Z=3.414， P<0.001）. The level of I-FABP increased with the increase in ACLF severity grade （H=17.385， P<0.001，P_trend<0.001）. The multivariate Cox regression analysis showed that I-FABP was independently associated with new-onset ACLF during follow-up （hazard ratio=2.138， 95% confidence interval ［CI］： 1.297 — 3.525， P=0.003）， and the tertile of I-FABP showed a good discriminatory ability （χ²=12.16， P<0.001）. The ROC curve showed that I-FABP had a good performance in predicting the development and progression of ACLF， with an area under the ROC curve of 0.854 （95%CI： 0.791 — 0.903） and 0.747 （95%CI： 0.661 — 0.820）， respectively， and an optimal cut-off value of 2.07 μg/L and 1.86 μg/L， respectively. ConclusionI-FABP can be used as a biomarker to predict the development and progression of ACLF， and it may help to identify high-risk patients and improve clinical management.