Elevated neopterin levels are associated with acute-on-chronic liver failure and mortality in patients with liver cirrhosis
| Autor: | Telma Erotides Silva, Karina Ghisoni de Oliveira, Camila Matiollo, Janaína Luz Narciso-Schiavon, Bruna Lenfers Turnes, Claudia Maccali, Leonardo de Lucca Schiavon, Elayne Cristina de Moraes Rateke, Alexandra Latini |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis Organ Dysfunction Scores Systemic inflammation Gastroenterology Neopterin Pathogenesis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine immune system diseases Internal medicine medicine Humans Decompensation In patient Prospective Studies Prospective cohort study Aged Hepatology business.industry Acute-On-Chronic Liver Failure Macrophage Activation Middle Aged medicine.disease Prognosis Survival Analysis chemistry ROC Curve 030220 oncology & carcinogenesis Biomarker (medicine) 030211 gastroenterology & hepatology Female medicine.symptom business Biomarkers Brazil |
| Zdroj: | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 52(7) |
| ISSN: | 1878-3562 |
| Popis: | Macrophage activation plays a central role in hepatic and systemic inflammation and is involved in the pathogenesis of acute-on-chronic liver failure (ACLF).This study aimed to investigate neopterin levels in patients admitted for acute decompensation (AD) of cirrhosis, evaluating its relationship with ACLF and prognosis.This prospective cohort study included 205 adult subjects hospitalized for AD of cirrhosis. Twenty-one healthy subjects and 89 patients with stable cirrhosis were evaluated as controls.Circulating neopterin was higher in AD as compared to stable cirrhosis and healthy controls (p0.001). ACLF was independently associated with higher neopterin levels (OR 1.015, 95% CI 1.002-1.028, p = 0.025). In the multivariate Cox regression analysis, neopterin levels (HR = 1.002, IC 95% 1.000-1.004, p = 0.041), Child-Pugh class C, and ACLF were predictors of 30-day survival. Among patients with ACLF, the Kaplan-Meier survival probability was 71.4% in those with neopterin levels25 nmol/L and 31.0% if neopterin ≥ 25 nmol/L (p0.001).Higher circulating neopterin was associated with ACLF in patients hospitalized for AD of cirrhosis. Neopterin levels were also independently predictors of high short-term mortality, especially among patients with ACLF, and could represent a useful biomarker of macrophage activation in clinical practice. |
| Databáze: | OpenAIRE |
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