Novel Biomarker for Early Detection of Severe Alcoholic Hepatitis

A bstract Background: Cytolysin-producing Enterococcus faecalis is more prevalent in alcoholic hepatitis (AH) patients, and this rise is correlated with the severity and mortality of the illness. Aim: To identify novel biomarkers for early detection of severe AH. Methods: A hospital-based case–control study was carried out with 51 AH patients and 49 control subjects. Stool samples were collected from both the study group and DNA was isolated. The presence of E. faecalis , cytolysin large sub-unit, and cytolysin small sub-unit was evaluated by PCR using their specific primers. Maddrey’s discriminant function (MDF) was used to evaluate the severity status of the AH patient. Pearson correlation was performed to evaluate the association between cytolysin positivity and severity scores. Results: Twenty patients tested positive for E. faecalis whereas none of the healthy control was found to be positive for E. faecalis. Cytolysin positivity was detected in 18 samples, out of which 17 were severe cases of AH and one was mild to moderate AH. At six months follow-up, a mortality rate of 38.89% was obtained from cytolysin-positive patients and 10.2% in healthy controls. A positive correlation of 0.599 was observed between cytolysin positivity and disease severity in the AH group. Conclusion: Cytolysin could be used as a potential biomarker for risk stratification of patients with AH.