Volume 16, Issue 10s, 2026
Beyond Transaminases: B2M, PGE2, and S1P as Novel Biomarkers for Staging Alcoholic Liver Disease
1+ Preetpal Singh, 2+ Sanjay Goyal, 1 Arushal Sharma, 1 Pratima Kumari, 1 Rupinder Kaur, 1 Sarita Jangra, 1* Ravinder Singh
1Chitkara College of Pharmacy, Chitkara University, Punjab, India
2Government Medical College and Rajindra Hospital, Patiala, Punjab, India
+Both authors contributed equally to this work and share first authorship.
Authors detail:
Preetpal Singh: preetpal533@gmail.com, preetpal.s@chitkara.edu.in
Sanjay Goyal: drsanjaymedi@gmail.com
Arushal Sharma: arushal20014.ccp@chitkara.edu.in
Pratima Kumari: pratima.kumari@chitkara.edu.in
Rupinder Kaur: rupinder@chitkara.edu.in
Sarita Jangra: sarita28787@gmail.com
1. Alcohol consumption elevates PGE2 rise in early ALD, driving inflammation and reduced QoL.
2. PGE2/S1P ratio strongly correlates with transaminases in steatosis, signalling early injury.
3. B2M shows strong AST association in cirrhosis linked to chronic alcohol effects.
4. S1P progressively rises across stages, supporting alcohol-induced fibrogenesis.
5. Stage-specific biomarkers diagnose the alcohol-related inflammation, fibrosis, and quality-of-life decline in ALD.
Image(s) provided by Servier Medical Art (https://smart.servier.com), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).
ABSTRACT
Background: The diagnosis of alcoholic liver disease (ALD) remains a significant clinical challenge. The aim of the study was to assess the diagnostic value of serum biomarkers (Beta-2 Microglobulin (B2M), Sphingosine-1-Phosphate (S1P), and Prostaglandin E2 (PGE2) and derived ratio (PGE2/S1P)) through the stages of ALD.
Methods: In this cross-sectional study, a total of 125 participants were enrolled. It includes 25 controls and 100 patients with ALD stratified into four equal groups of steatosis, steatohepatitis, fibrosis, and cirrhosis according to clinical, biochemical, and imaging. The serum biomarkers were measured by enzyme-linked immunosorbent assay (ELISA). Liver functioning tests, alcohol intake habits (AUDIT), and health related quality of life (HRQoL, through CLDQ) were evaluated. Statistical tests were one-way ANOVA using post-hoc tests, Pearson correlation and linear regression.
Results: Serum levels of B2M, PGE2, S1P, and the PGE2/S1P ratio were significantly elevated across the ALD spectrum. Within-group analysis indicates stage-related biomarker correlation patterns. The transaminases had strong relationships with PGE2 and PGE2/S1P in early disease stages, whereas B2M demonstrated stronger correlations in later stages. The three biomarkers were positively correlated with conventional markers of liver damage, parameters of alcohol consumption and negatively with measures of quality of life.
Conclusion: Serum B2M, PGE2, S1P and PGE2/S1P shows potential as non-invasive stage-specific biomarkers for diagnosis of ALD. The integration of these biomarkers into clinical practice could be used for stratification and monitoring of ALD progression.
Keywords: Alcoholic liver disease; Non-invasive diagnosis; Quality of life; Biomarkers; Beta-2 Microglobulin; Sphingosine-1-Phosphate; Prostaglandin E2.
How to cite this article: Singh P, Goyal S, Sharma A, Kumari P, Kaur R, Jangra S, Singh R. Beyond Transaminases: B2M, PGE2, and S1P as Novel Biomarkers for Staging Alcoholic Liver Disease. Int J Drug Deliv Technol. 2026;16(10s): 260-273; DOI: 10.25258/ijddt.16.10s.38
Source of support: Nil.
Conflict of interest: None