title: Tumor necrosis factor alpha and interleukin 6 plasma levels in infected cirrhotic patients.
abstract: BACKGROUND
  Patients with liver cirrhosis disclose both increased production and decreased metabolism of tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6). The present study analyzes the characteristic pattern of these cytokines during sepsis in cirrhotics.
  
  
  METHODS
  TNF-alpha and IL-6 plasma levels, measured during 15 days from the onset of cirrhotic decompensation or of the septic event, were compared between 14 infected patients with liver cirrhosis, 18 uninfected decompensated cirrhotic patients, and 35 septicemic patients devoid of liver disease. Cytokines were measured using immunoassays.
  
  
  RESULTS
  In infected cirrhotics, initial levels of both TNF-alpha and IL-6 were significantly higher than in noninfected cirrhotic patients (P < 0.0001) or in septicemic patients devoid of cirrhosis (P < 0.001). Initial IL-6 plasma levels (threshold, 200 pg/mL) showed 89% specificity and 100% sensitivity in discriminating cirrhotic decompensation due to infection from that caused by other factors. TNF-alpha and IL-6 plasma levels remained significantly higher for many days in infected cirrhotic patients compared with the other two groups.
  
  
  CONCLUSIONS
  Both the profoundly increased initial levels of TNF-alpha and IL-6 and their persistence over days after sepsis onset seem characteristic of the cirrhotic patients. The exact relationship between prolonged exposure to TNF-alpha and poor prognosis in these patients is unknown, but it might represent a unique opportunity for the use of anti-TNF-alpha antibodies during sepsis.
authors: Infectious Diseases Clinic, Erasme University Hospital, Brussels, Belgium.
authors: B
authors: B
authors: Byl
authors: I
authors: I
authors: Roucloux
authors: A
authors: A
authors: Crusiaux
authors: E
authors: E
authors: Dupont
authors: J
authors: J
authors: Devière
mesh_terms: D000368:Aged; D001424:Bacterial Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha