PROFILE OF PRO AND ANTI-INFLAMMATORY CYTOKINES IN PATIENTS WITH CHRONIC LIVER DISEASE IN THE COMPENSATION, INFLAMMATION AND IMMUNOSUPPRESSION PHASES

Introduction and objectives

Decompensated cirrhosis is defined by the onset of complications and is associated with immune dysfunction. This is the result of two processes: systemic inflammation and damage made by the immune system. Our objective was to determine the profile of pro and anti inflammatory cytokines in patients with chronic liver disease: alcoholic (OH), non-alcoholic steatohepatitis (NASH), autoimmune liver disease (AILD) and hepatitis C (HCV), in the phases of compensation, inflammation and immunosuppression, based on functional classifications and prognosis with the CHILD- PUGH, MELD and D'Amico scales.

Methods and materials

Prospective, observational, and cross-sectional study, made in the University Hospital, Dr. Jose E. Gonzalez during 2019-2020. A total of 108 patients were included: 28 OH, 27 NASH, 25 HCV and 27 AILD. The diagnosis and functional classification was made according to international guidelines. Inclusion criteria: over 18 years of age, signed informed consent. Exclusion criteria: hepatocellular carcinoma, other autoimmune pathologies. Blood samples (10 ml) were collected to quantify TNF-a, IL-8, IL-10, IL-1, IL-6. The protocol was approved by the ethics committee with registration MI20-0002. A one-way ANOVA was used to determine the differences between groups and stages

Results

In OH, there is an increase in IL-6 and IL-8 in the decompensation phase, Child-Pugh stage C, D'amico stage 5 and MELD from 25 to 34 points. NASH patients had an increase in IL-8 in the inflammation phase as assessed by Child-Pugh B and D'amico 3 and 4. There was an increase in IL-6 in the immunosuppression phase. In patients with HCV and AILD, increased serum levels of IL-8 and IL-6 were shown in decompensation stages (Figure 1).

Discussion

In this study, we demonstrated a significant increase in the pro-inflammatory cytokine profile in patients in the inflammation and immunosuppression phases. Fischer J et al. reported that a greater understanding of the mechanisms associated with immune dysfunction has led to the identification of possible therapeutic targets, with the intention of reducing the risk of infection and preventing decompensation events and disease progression.

Conclusion

This study demonstrated a significant increase in the pro-inflammatory cytokine profile (IL-8 and IL-6) as cirrhosis progresses. This is consistent with in the inflammation and immunosuppression phases, assessed by the Child-Pugh severity scales in stages B and C, D'amico from stages 3 to 5 and MELD> from 16 to 24 points and from 25 to 34 points. in the four etiologies included, being statistically significant.

The authors declare no conflict of interest.

This work was sponsored by PAICYT-UANL-SA830-19.