CHI3L1 combined with Th17/Treg cells: a novel marker for the degree of HBV-related liver fibrosis

Several methods are available to differentiate non-fibrosis from advanced liver fibrosis; however, data regarding intermediate stages remain limited. A total of 246 patients with chronic hepatitis B (CHB) were enrolled and classified into four groups according to fibrosis stage: non- or mild fibrosis (Group A), significant fibrosis (Group B), progressive fibrosis (Group C), and cirrhosis (Group D). The serum chitinase-3-like protein 1 (CHI3L1) levels in Groups A, B, C, and D were 40.33, 52.96, 92.28, and 153.63 μg/L, respectively. Significant differences were observed between Groups A and B (<i>p</i> = 0.040), Groups C and D (<i>p</i> < 0.0001), and Groups B and D (<i>p</i> < 0.0001). The percentage of regulatory T cells (Tregs) was 0.67 in the CHB-low fibrosis (CHB-L) group and 0.26 in the CHB-moderate to severe fibrosis (CHB-MS) group, representing a statistically significant difference (<i>p</i> = 0.039). The T helper 17 cells (Th17)/Treg ratio was 10.00 in the CHB-L group and 61.26 in the CHB-MS group, representing a statistically significant difference (<i>p</i> = 0.010). For predicting significant fibrosis, progressive fibrosis, and cirrhosis, the area under the curve (AUC) for the combined conventional markers - hyaluronic acid, laminin, type III procollagen N-terminal peptide, collagen type IV, and cholyglycine were 0.736, whereas those for CHI3L1 and Th17/Treg were 0.774 and 0.750, respectively. The combination of CHI3L1 and Th17/Treg cells yielded an AUC of 0.814, demonstrating the highest sensitivity (100%) and high specificity. These findings suggest that CHI3L1 combined with Th17/Treg cells may serve as a novel biomarker for staging hepatitis B virus-related liver fibrosis.