Neopterin and interleukin-8--prognosis in alcohol-induced cirrhosis.
BACKGROUND
Neutrophil cytotoxity and activated macrophages have been implicated in the pathogenesis of alcohol-induced liver disease. The aim of this study was to relate plasma levels of neopterin, a marker of activation of the cellular immune system, and IL-8, a neutrophil chemotactic factor, with severity of liver disease and prognosis in patients with alcohol-induced cirrhosis.


METHODS
Plasma concentrations of neopterin and IL-8 were assessed in 81 patients with alcohol-induced cirrhosis admitted to the Department of Medicine B, Bispebjerg Hospital, Copenhagen, Denmark, and in 16 healthy controls. After a median follow-up period of 5 years, mortality and death causes were registered. The patients were divided into groups according to the major contributing cause of death: infection, upper gastrointestinal bleeding or hepatic coma.


RESULTS
Neopterin and IL-8 levels were increased in the cirrhosis patients, but not significantly related to Child-Pugh classification. Five-year mortality was 67%. High neopterin levels (>upper quartile) were an independent predictor of death (p=0.01, Log rank and p<0.02, Cox). High IL-8 levels (>upper quartile) were of no significant prognostic value for overall mortality. Causes of death related mortality were as follows (Log rank): Neopterin; p=0.009, p=0.84 and p=0.94, and IL-8; p=0.36, p=0.002 and p=0.27, respectively, according to infection, bleeding and coma as causes of death.


CONCLUSIONS
Neopterin and IL-8 plasma levels are raised in patients with alcohol-induced cirrhosis, and are predictive of mortality associated with infections and upper gastrointestinal bleeding, respectively.
Homann
C
C
Department of Medicine I, HS Bispebjerg Hospital, Copenhagen, Denmark.
Benfield
T L
TL
Graudal
N A
NA
Garred
P
P
D002423:Cause of Death; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000473:pathology; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications / Q000401:mortality / Q000473:pathology*; D019798:Neopterin / Q000097:blood*; D011014:Pneumonia / Q000209:etiology / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D015996:Survival Rate
D016209:Interleukin-8; D019798:Neopterin