Ascites fluid and plasma calprotectin concentrations in liver disease.
BACKGROUND
Calprotectin, a marker of neutrophil activation, has been associated with a poor prognosis in alcohol-induced cirrhosis. The aims were to study concentrations of calprotectin in patients with various liver diseases, and to further investigate the prognostic value of calprotectin in cirrhosis.


METHODS
Plasma calprotectin concentrations were determined in 84 patients with alcohol-induced liver disease, 32 hepatitis B or C infected patients, 33 patients with liver disease of other aetiologies, 7 patients with combined aetiologies and in 24 patients with malignant disease. Thirty healthy individuals were included as controls. Ascites calprotectin concentrations were determined in patients with ascites (n = 75). Follow-up for survival was performed after a median observation period of 10 months.


RESULTS
Increased plasma and ascites calprotectin concentrations were observed in malignant disease compared to non-malignant disease (P < 0.0001). Plasma calprotectin concentrations were low in viral liver disease compared to patients with non-viral liver disease (P = 0.02) and to controls (P = 0.0002). Plasma calprotectin (>median) was a highly significant marker of poor survival in alcohol-induced cirrhosis (P = 0.001), but was of no prognostic value in non-alcohol-induced cirrhosis (P = 0.88). In decompensated cirrhosis high (>upper quartile) ascites calprotectin concentrations were associated with an increased mortality (P = 0.002), as were high (>median) plasma calprotectin levels (P = 0.009).


CONCLUSIONS
The prognostic importance of calprotectin in alcohol-induced cirrhosis is confirmed and demonstrated as specific for alcohol-induced liver disease. Low calprotectin levels are indicated in viral liver disease, and an association between high ascites calprotectin levels and malignant ascites was observed.
Dept. of Medical Gastroenterology C, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. homann@post6.tele.dk
C
C
Homann
E
E
Christensen
P
P
Schlichting
E K
EK
Philipsen
N A
NA
Graudal
P
P
Garred
D001202:Ascitic Fluid / Q000737:chemistry*; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis / Q000097:blood*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000473:pathology; D008107:Liver Diseases / Q000097:blood* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis
D039841:Leukocyte L1 Antigen Complex