title: Neutrophil activation in chronic liver disease.
abstract: OBJECTIVE
  To assess the relationship between neutrophil activation and indices of disease severity in patients with chronic liver disease.
  
  
  METHODS
  Plasma neutrophil elastase was measured by radioimmunoassay as a marker of neutrophil activation, and disease severity assessed by standard clinical, biochemical, haematological and histological techniques.
  
  
  METHODS
  Eighty-eight patients with chronic liver disease were studied, Thirty-nine had alcohol-induced liver disease (ALD), 18 autoimmune chronic hepatitis, 13 cryptogenic cirrhosis, seven primary biliary cirrhosis, six primary sclerosing cholangitis, three haemochromatosis and two secondary biliary cirrhosis. Seventy-three patients were cirrhotic and 15 were non-cirrhotic, confirmed by biopsy.
  
  
  RESULTS
  Levels of neutrophil elastase were raised in Childs C cirrhotic patients with ALD compared with Childs A or B patients with ALD (P < 0.01), Childs A or B patients with non-ALD (P < 0.01), and Childs C patients with non-ALD (P = 0.02). In patients with ALD, neutrophil elastase correlated with prothrombin time (r = 0.679, P = 0.001), bilirubin (r = 0.587, P < 0.001), Child-Pugh score (r = 0.546, P < 0.001) and inversely with serum albumin (r = -0.511, P < 0.001). In patients with non-ALD, there were no correlations with the measurements of with transaminase levels.
  
  
  CONCLUSIONS
  Neutrophil activation, as measured by plasma neutrophil elastase, is a marker of disease severity in patients with alcohol-induced chronic liver damage, but not in those with other causes of liver disease.
authors.affiliation: Centre for Liver and Digestive Diseases, Royal Infirmary of Edinburgh, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Stanley
authors.forename: I R
authors.initials: IR
authors.lastname: MacGregor
authors.forename: J F
authors.initials: JF
authors.lastname: Dillon
authors.forename: I A
authors.initials: IA
authors.lastname: Bouchier
authors.forename: P C
authors.initials: PC
authors.lastname: Hayes
mesh_terms: D001327:Autoimmune Diseases / Q000276:immunology; D015209:Cholangitis, Sclerosing / Q000276:immunology; D002908:Chronic Disease; D006432:Hemochromatosis / Q000276:immunology; D006505:Hepatitis / Q000276:immunology; D006801:Humans; D019272:Leukocyte Elastase; D008103:Liver Cirrhosis / Q000276:immunology; D008105:Liver Cirrhosis, Biliary / Q000276:immunology; D008107:Liver Diseases / Q000276:immunology*; D008108:Liver Diseases, Alcoholic / Q000276:immunology; D018375:Neutrophil Activation; D010196:Pancreatic Elastase / Q000097:blood; D012720:Severity of Illness Index
chemical_list: D010196:Pancreatic Elastase; D019272:Leukocyte Elastase