Association of ANXA3 methylation with clinical outcomes of glucocorticoid therapy in patients with hepatitis B virus-related acute-on-chronic liver failure

There are individual differences in the efficacy of glucocorticoid therapy for hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Annexin A3 (ANXA3), as a potential biomarker, may be associated with the clinical outcomes of glucocorticoid therapy in HBV-ACLF patients. We enrolled 108 HBV-ACLF patients receiving glucocorticoid therapy to assess the effects of glucocorticoid therapy on ANXA3 mRNA and methylation levels in peripheral blood mononuclear cells. At the same time, clinical parameters during therapy were collected. In HBV-ACLF patients who survived, ANXA3 expression significantly decreased after glucocorticoid therapy, while methylation levels increased. No significant changes were observed in non-survivors. Logistic regression analysis of 90-day follow-up further indicated that ANXA3 methylation levels could serve as an independent predictor of glucocorticoid treatment response, with its elevation significantly correlating with favorable clinical outcomes. In HBV-ACLF patients, ANXA3 methylation levels were associated with clinical outcomes following glucocorticoid therapy, suggesting its potential as a candidate therapy-associated prognostic biomarker.