The Connection Between Liver Disease and Chitinase Proteins
The Connection Between Liver Disease and Chitinase Proteins
Chitinase and chitinase like proteins are members of the 18-glycosyl-hydrolase family.
 Several reports have linked the chitinase 3 like 1 protein with colitis, asthma and liver
 disease.

 This study aims to evaluate the correlation of chitinase 3 like 1 protein with clinical
 parameters such as disease severity, reaction to treatment, portal hypertension and
 prognosis.
Chitin is a poly saccharide, abundant in insects, fungi, crustaceans and other organisms, but
 not in mammals. Chitinases and chitinase like proteins (which have the ability to bind chitin
 without enzymatic activity) are members of the 18-glycosyl-hydrolase family. Their function
 and importance are still not clearly understood. However, several reports have linked the
 chitinase 3 like 1 protein with colitis and asthma. Furthermore, Johansen et al have reported
 elevated levels of chitinase 3 like 1 protein in patients with liver disease, mainly those
 with alcoholic liver disease (ALD) and fibrosis. This report consisted of 51 patients with
 ALD ,but only 16 and 17 patients with fatty liver and viral hepatitis respectively.

 This study aims to evaluate the correlation of chitinase 3 like 1 protein with clinical
 parameters such as disease severity, reaction to treatment, portal hypertension (when
 measured) and prognosis.

 ***Study design:

 a. Subjects i.The study will include patients with liver disease followed at the liver unit,
 Hadassah Medical Center, Jerusalem. b. Planned number i.The study is planned to include 200
 volunteers. c. Inclusion criteria i.Patients with liver disease followed at the liver unit at
 Hadassah Medical Center. ii.Patients who have given their informed consent for participation
 in the study. d. Exclusion criteria i.Age<18y. ii.Pregnancy iii.Patients with other
 conditions associated with elevated chitinase 3 like 1 protein (such as asthma and rheumatoid
 arthritis). e. Chitinase 3 like-1 protein levels will be measured by a commercially available
 kit (Human Chitinase 3-like 1 Quantikine ELISA Kit, catalogue number - DC3L1, Biotest LTD).
 f. Stopping/modifying criteria i.At subjects' request. g. Trial entry and enrollment i.A
 consecutive cohort will be recruited form amongst the patients followed at the liver unit in
 Hadassah medical center. Jerusalem Israel. ii.Consenting patients will have a blood test
 drawn for chitinase 3 like 1 protein levels. iii.Clinical details of each patient will be
 obtained form the liver unit. iv.In addition to the routine follow up at the liver unit,
 follow up will be performed at 1,2 and 5 years. h. Statistical considerations i.Subjects will
 be grouped according to their clinical properties (disease, treatment, severity, portal
 hypertension) ii.Chitinase 3 like 1 protein levels will be compared between each group. F.
 Informed consent i.Each subject will be enrolled and enter the study only after giving an
 informed consent. G. Adherence to study eligibility i.The study will be conducted in
 accordance with good clinical practice (GCP) guidelines, and the study protocol. H.
 Safeguarding of documents i.The privacy of the subjects and all confidentiality issues will
 be handled in accordance with applicable law and guidelines of the institution and the
 Helsinki Committee, the Israeli ministry of health, or the other appropriate regulatory
 authorities.
Inclusion Criteria:

 -  Patients with liver disease followed at the liver unit at Hadassah Medical Center.

 -  Patients who have given their informed consent for participation in the study

 Exclusion Criteria:

 -  Age<18y.

 -  Pregnancy

 -  Patients with other conditions associated with elevated chitinase 3 like 1 protein
 (such as asthma and rheumatoid arthritis).