From stable disease to acute-on-chronic liver failure: Circulating cytokines are related to prognosis in different stages of cirrhosis.

Autor: Fischer J; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Silva TE; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Soares E Silva PE; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Colombo BS; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Silva MC; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Wildner LM; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Bazzo ML; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Rateke EC; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Frode TS; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Mello SV; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Rosa JS; Department of Clinical Analysis, Federal University of Santa Catarina, Brazil., Dantas-Correa EB; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Narciso-Schiavon JL; Division of Gastroenterology, Federal University of Santa Catarina, Brazil., Schiavon LL; Division of Gastroenterology, Federal University of Santa Catarina, Brazil. Electronic address: leo-jf@uol.com.br.
Jazyk: angličtina
Zdroj: Cytokine [Cytokine] 2017 Mar; Vol. 91, pp. 162-169. Date of Electronic Publication: 2017 Jan 09.
DOI: 10.1016/j.cyto.2016.12.017
Abstrakt: Introduction: Although both pro- and anti-inflammatory circulating cytokines are known to be elevated in liver cirrhosis, its clinical significance is not completely recognized. Our aim was to evaluate the prognostic significance of circulating cytokines interleukin (IL)-6, IL-17 and IL-10 in different stages of cirrhosis.
Methods: This prospective study included two cohorts: (1) stable cirrhosis attended in the Outpatient Clinic (n=118), and (2) subjects hospitalized for acute decompensation (AD) (n=130). Thirty healthy subjects served as control group.
Results: Patients with cirrhosis exhibited higher levels of cytokines as compared to controls. In stable cirrhosis, during a median follow-up of 17months, liver-related events occurred in 26 patients. Higher IL-10 levels and Child-Pugh B/C were independently associated with reduced event-free survival. In AD cohort, death after 90days of follow-up occurred in 39 patients and was independently associated with ascites, higher IL-6 and model for end-stage liver disease. IL-6 levels also showed higher AUROC than CRP for predicting bacterial infection in the AD cohort (0.831±0.043vs. 0.763±0.048, respectively). IL-17 decreased at third day of hospitalization only in patients who progressed to death. Higher IL-6 levels were observed in acute-on-chronic liver failure (ACLF) patients even in the absence of bacterial infection whereas IL-10 was higher only in subjects with infection-related ACLF. Higher IL-10 and IL-17 levels were associated with progression to death in ACLF.
Conclusions: The pattern of immune response seems to vary according to the phase of cirrhosis and is related to prognosis, from stable disease to ACLF.
(Copyright © 2017 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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