# Post-Translational Changes in Serum Albumin in Patients with Alcohol-Associated Hepatitis

## TL;DR

This study found that patients with alcohol-related liver disease have altered forms of a key blood protein, but these changes did not predict survival.

## Contribution

The study characterizes post-translational modifications of serum albumin in alcohol-associated hepatitis patients and assesses their clinical relevance.

## Key findings

- AH patients showed significantly different serum albumin isoform profiles compared to healthy controls.
- Native serum albumin levels increased during hospitalization but did not correlate with survival outcomes.
- Oxidized forms of serum albumin were more prevalent in AH patients.

## Abstract

Post-translational modifications of human serum albumin (HSA) have been described in patients with liver disease. This prospective cohort study aimed to characterize HSA microheterogeneity in hospitalized patients with alcohol-associated hepatitis (AH) and investigate its clinical relevance. We analyzed HSA isoforms by mass spectrometry in 49 patients with AH (at admission and day 14) and 20 healthy controls. Survival at 30, 90, and 365 days was assessed. Differences in HSA isoform abundance were compared between controls and AH patients, as well as between 90-day survivors and non-survivors. AH patients (69% male, median age 53 years) exhibited a significantly different HSA form profile compared to controls, with a lower amount of native HSA and higher oxidized forms. Native HSA negatively correlated with total HSA concentration (R = −0.47, p < 0.001). The relative amount of native HSA increased non-significantly from admission to day 14, but its estimated concentration increased significantly (8.8 vs. 12.0 g/L, p = 0.005). There were no significant differences in HSA forms between 90-day survivors and non-survivors at admission or day 14. Patients with AH exhibit extensive post-translational modifications of HSA compared to healthy individuals. While HSA forms changed during early hospitalization, they did not significantly correlate with short-term mortality in this cohort.