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SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis

Athwal, Varinder S.; Pritchett, James; Martin, Katherine; Llewellyn, Jessica; Scott, Jennifer; Harvey, Emma; Zaitoun, Abed M; Mullan, Aoibheann F; Zeef, Leo A H; Friedman, Scott L; Irving, William L.; Hanley, Neil A; Guha, Indra N; Hanley, Karen Piper


Varinder S. Athwal

James Pritchett

Katherine Martin

Jessica Llewellyn

Jennifer Scott

Emma Harvey

Abed M Zaitoun

Aoibheann F Mullan

Leo A H Zeef

Scott L Friedman

Neil A Hanley

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Professor of Hepatology

Karen Piper Hanley


Extracellular matrix (ECM) deposition and resultant scar play a major role in the pathogenesis and progression of liver fibrosis. Identifying core regulators of ECM deposition may lead to urgently needed diagnostic and therapetic strategies for the disease. The transcription factor Sex determining region Y box 9 (SOX9) is actively involved in scar formation and its prevalence in patients with liver fibrosis predicts progression. In this study, transcriptomic approaches of Sox9-abrogated myofibroblasts identified >30% of genes regulated by SOX9 relate to the ECM. Further scrutiny of these data identified a panel of highly expressed ECM proteins, including Osteopontin (OPN), Osteoactivin (GPNMB), Fibronectin (FN1), Osteonectin (SPARC) and Vimentin (VIM) as SOX9 targets amenable to assay in patient serum. In vivo all SOX-regulated targets were increased in human disease and mouse models of fibrosis and decreased following Sox9-loss in mice with parenchymal and biliary fibrosis. In patient serum samples, SOX9-regulated ECM proteins were altered in response to fibrosis severity, whereas comparison with established clinical biomarkers demonstrated superiority for OPN and VIM at detecting early stages of fibrosis. These data support SOX9 in the mechanisms underlying fibrosis and highlight SOX9 and its downstream targets as new measures to stratify patients with liver fibrosis.


Athwal, V. S., Pritchett, J., Martin, K., Llewellyn, J., Scott, J., Harvey, E., …Hanley, K. P. (2018). SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis. Scientific Reports, 8(1), Article 17905.

Journal Article Type Article
Acceptance Date Oct 27, 2018
Online Publication Date Dec 17, 2018
Publication Date Dec 17, 2018
Deposit Date Nov 12, 2018
Publicly Available Date Dec 17, 2018
Journal Scientific Reports
Print ISSN 2045-2322
Electronic ISSN 2045-2322
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 8
Issue 1
Article Number 17905
Public URL
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