To observe the changes of serum levels of nuclear factor-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in patients with primary biliary cholangitis (PBC) before and after treatment, and to explore their correlation with short-term effects of ursodeoxycholic acid (UDCA).

A total of 80 patients with PBC and 80 healthy controls were enrolled at the First Hospital of Shanxi Medical University. The clinical data and serum samples of patients with PBC were collected before and after treatment. The contents of Nrf2 and HO-1 in the samples were detected by ELISA. The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) were detected by the methods of tartaric acid and xanthine oxidase. The changes in serum Nrf2 and HO-1 levels in patients with PBC before and after UDCA treatment and their clinical significance were then analyzed.

The contents of serum Nrf2 and HO-1 in PBC patients before treatment were [(626.07±103.95) U/L and (16.62±5.06 U/L), respectively], significantly higher than those of healthy controls [(164.45±35.12) U/L and (11.74±2.0) U/L, respectively; P<0.001]. Compared with the values before treatment, the contents of serum Nrf2 [(754.30±104.36) U/L] and HO-1 [(22.60±5.51)U/L] in PBC patients were increased significantly, and liver function indexes were also improved significantly after treatment (P<0.001). The increase of Nrf2 and HO-1 contents in the cured group and the marked group was particularly significant (P<0.001). The contents of serum Nrf2 (r=0.751, P=0.012) and HO-1 (r=0.621, P=0.038) before treatment were positively correlated with the treatment effect. Using pretreatment Nrf2=586.17 U/L as a threshold, the sensitivity for predicting short-term efficacy of UDCA was 84.6%, the specificity was 77.5%, and the area under the curve was 0.824 (P<0.05). Using pretreatment HO-1=14.92 U/L as a threshold, the sensitivity for predicting short-term efficacy of UDCA was 88.5%, the specificity was 75.0%, and the area under the curve was 0.861 (P<0.05).

Nrf2/HO-1 play an important role in the disease process of PBC patients. The baseline levels and dynamic changes of Nrf2/HO-1 in serum are related to the therapeutic effect of UDCA, which can predict the response of PBC patients to short-term treatment of UDCA.