Circulating histone H4 values can relate to disease severity in patients with alcoholic hepatitis and cirrhosis.

Objective: We aimed to evaluate whether serum histone H4 (sHH4) is associated with alcoholic liver disease (ALD) phenotypes.

Methods: This case-control study included 66 ALD patients and 47 healthy controls (HCs). Patients with ALD were classified into three groups: alcohol-associated steatotic liver, alcoholic hepatitis (AH), and alcoholic cirrhosis (AC). The HIST1H4A kit was used for the enzyme-linked immunosorbent assay of sHH4.

Results: In the AH patients, the median sHH4 value was the highest and the lowest in the HC (3572.32 ng/L vs. 451 ng/L, respectively, p = 0.002). In the AC group, the median sHH4 value was higher in the Child-Pugh classification B (CPC-B) group than in the CPC-A group (p = 0.026). Positive correlations existed between the sHH4 value and the duration of alcohol use and Maddrey's discriminant function scores in patients with AH (rho = 0.886, p = 0.019 for both). In the AC patients, a positive correlation was noted between the sHH4 values and The Model for End-stage Liver Disease Sodium scores (rho = 0.527, p = 0.006).

Conclusions: Increased sHH4 values might be a marker for the severity of AH and AC.