Effect of liver transplantation on tuftsin activity and phagocytic activity of neutrophil granulocytes in patients with liver cirrhosis.
BACKGROUND
Tuftsin activity (TA) is reduced in cirrhosis. This contributes to the defective phagocytic activity (PA) of neutrophil granulocytes and is related to the impairment of splenic function. Orthotopic liver transplantation (OLT) cures cirrhosis and might restore TA. This study was aimed at determining if OLT restores TA and PA.


METHODS
We measured in 9 cirrhotic patients, before and after successful OLT, TA by a bioassay and PA by chemiluminescence in which neutrophils of the patient were tested with both autologous (PA1) and pooled sera from healthy subjects (PA2). Splenic function was assayed by the pitted red cell count.


RESULTS
Before OLT, TA was reduced in 7 patients, and PA1 in all the patients. Pitted cell count was elevated in all the patients. After OLT (median 39 months; range 21-49), TA improved in all cases [median: from 8% (5-16%) to 20% (9-22%), p < 0.008], normalizing in 5 out of the 7 patients with low values. PA1 improved in all the patients [from 102 cpm (65-128 cpm) to 235 cpm (78-280 cpm), p < 0.008], normalizing in 5. Pitted red count decreased in 7 patients and normalized in 3 [from 3.3% (2.1-6.0%) to 2.4% (1.4-2.8%), p < 0.021]. Platelet count [from 55 x 10(3) (30-100) to 185 x 10(3) (93-286), p < 0.008] and leucocyte count [from 3.60 x 10(3) (1.81-5.23) to 5.53 x 10(3) (3.31-6.71), p < 0.008] also improved.


CONCLUSIONS
OLT improves TA and PA of cirrhotic patients. This effect is associated with an improvement of both functional hyposplenism and haematological hypersplenism. The restoration of natural defences against infections may mitigate the adverse effect of immunosuppressive treatment.
Foschi
Francesco Giuseppe
FG
Dipartimento di Medicina Interna, Ospedale per gli Infermi, Faenza, Italia.
Trevisani
Franco
F
Loggi
Elisabetta
E
Parazza
Monica
M
Melotti
Cristina
C
Bedeschi
Enrico
E
Mingazzini
Lorenza
L
Cappa
Federica Mirici
FM
Cescon
Matteo
M
Andreone
Pietro
P
Grazi
Gianluca
G
Stefanini
Giuseppe Francesco
GF
Bernardi
Mauro
M
D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000276:immunology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D010587:Phagocytosis; D014405:Tuftsin / Q000172:deficiency / Q000378:metabolism*
D014405:Tuftsin