Molecular Medicine

, Volume 18, Issue 11, pp 1421–1429 | Cite as

Augmenter of Liver Regeneration (ALR) Is a Novel Biomarker of Hepatocellular Stress/Inflammation: In Vitro, In Vivo and In Silico Studies

  • Yoram Vodovotz
  • John Prelich
  • Claudio Lagoa
  • Derek Barclay
  • Ruben Zamora
  • Noriko Murase
  • Chandrashekhar R. Gandhi
Research Article


The liver is a central organ involved in inflammatory processes, including the elaboration of acute-phase proteins. Augmenter of liver regeneration (ALR) protein, expressed and secreted by hepatocytes, promotes liver regeneration and maintains viability of hepatocytes. ALR also stimulates secretion of inflammatory cytokines (tumor necrosis factor [TNF]-α and interleukin [IL]-6) and nitric oxide from Kupffer cells. We hypothesized that ALR may be involved in modulating inflammation induced by various stimuli. We found that hepatic ALR levels are elevated at 24 h, before or about the same time as an increase in the mRNA expression of TNF-α and IL-6, after portacaval shunt surgery in rats. Serum ALR also increased, but significantly only on d 4 when pathological changes in the liver become apparent. In rats, serum ALR was elevated after intraperitoneal administration of lipopolysaccharide alone and in a model of gram-negative sepsis. Serum ALR increased before alanine aminotransferase (ALT) in endotoxemia and in the same general time frame as TNF-α and IL-6 in the bacterial sepsis model. Furthermore, mathematical prediction of tissue damage correlated strongly with alterations in serum ALR in a mouse model of hemorrhagic shock. In vitro, monomethyl sulfonate, TNF-α, actinomycin D and lipopolysaccharide all caused increased release of ALR from rat hepatocytes, which preceded the loss of cell viability and/or inhibition of DNA synthesis. ALR may thus serve as a potential diagnostic marker of hepatocellular stress and/or acute inflammatory conditions.



This work was supported by VA Merit Review 1I1BX001174 and NIH grants R01-DK54411 and R21AA020846 (CR Gandhi). We thank Adam Kichler for technical assistance.

The content of this article does not represent the views of the Department of Veterans Affairs or the U.S. Government.


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Authors and Affiliations

  • Yoram Vodovotz
    • 1
    • 2
  • John Prelich
    • 4
  • Claudio Lagoa
    • 1
  • Derek Barclay
    • 1
  • Ruben Zamora
    • 1
    • 2
  • Noriko Murase
    • 1
    • 5
  • Chandrashekhar R. Gandhi
    • 1
    • 3
    • 5
    • 6
  1. 1.Department of SurgeryUniversity of PittsburghPittsburghUSA
  2. 2.Center for Inflammation and Regenerative ModelingMcGowan Institute for Regenerative MedicinePittsburghUSA
  3. 3.Department of PathologyUniversity of PittsburghPittsburghUSA
  4. 4.VA Pittsburgh Healthcare SystemPittsburghUSA
  5. 5.Thomas E. Starzl Transplantation InstituteUniversity of PittsburghPittsburghUSA
  6. 6.current affiliation: Department of SurgeryUniversity of CincinnatiCincinnatiUSA

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