Novel Biomarkers of Hepatitis B and Hepatocellular Carcinoma: Clinical Significance of HBcrAg and M2BPGi

Int J Mol Sci. 2020 Jan 31;21(3):949. doi: 10.3390/ijms21030949.

Abstract

The hepatitis B virus (HBV) cannot be removed completely from infected hepatocytes, owing to the presence of intrahepatic covalently closed circular DNA (cccDNA). As chronic hepatitis B (CHB) can progress to cirrhosis and hepatocellular carcinoma (HCC), predicting HCC development in high-risk patients with high viral replicative activity or advanced fibrosis is important. Novel serological biomarkers reflect intrahepatic viral replicative activity or the progression of liver fibrosis, indicating non-invasive alternatives to liver biopsy: (1) Hepatitis B core-related antigen (HBcrAg) correlates with serum HBV DNA and intrahepatic cccDNA. In CHB patients, a decrease in HBcrAg is associated with favorable outcomes. HBcrAg can predict HCC occurrence or recurrence. (2) Measurement of the Mac-2 binding protein glycosylation isomer (M2BPGi) has been introduced for the evaluation of liver fibrosis. An increase in M2BPGi in CHB patients is related to the progression of liver fibrosis and high potential (risk) of HCC development. Here, we describe the clinical applications of HBcrAg and M2BPGi in CHB patients. Additionally, because new potential therapeutic agents that eliminate intrahepatic cccDNA are being developed, monitoring of HBcrAg or M2BPGi might be suitable for evaluating therapeutic effects and the clinical outcomes. In conclusion, these would be appropriate surrogate markers for predicting disease progression.

Keywords: Wisteria floribunda agglutinin-positive Mac-2 binding protein; chronic hepatitis B (CHB); cirrhosis; hepatitis B core-related antigen (HBcrAg); hepatocellular carcinoma (HCC); intrahepatic covalently closed circular DNA (cccDNA); liver fibrosis.

Publication types

  • Review

MeSH terms

  • Antigens, Neoplasm / blood*
  • Biomarkers / blood
  • Biomarkers, Tumor / blood*
  • Carcinoma, Hepatocellular / immunology
  • Carcinoma, Hepatocellular / metabolism
  • Carcinoma, Hepatocellular / virology*
  • DNA, Circular / metabolism
  • Disease Progression
  • Hepatitis B Core Antigens / blood*
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / metabolism*
  • Humans
  • Liver Neoplasms / immunology
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / virology*
  • Up-Regulation

Substances

  • Antigens, Neoplasm
  • Biomarkers
  • Biomarkers, Tumor
  • DNA, Circular
  • Hepatitis B Core Antigens
  • LGALS3BP protein, human