title: Pro-inflammatory interleukin-18 and Caspase-1 serum levels in liver failure are unaffected by MARS treatment.
abstract: BACKGROUND
  The pro-inflammatory cytokine IL-18 and its activator Caspase-1 are involved in acute liver failure and acute-on-chronic-liver-failure. In acute liver failure and acute-on-chronic-liver-failure, the MARS system has been used to support liver function. Enhancement of IL-18, as seen in other extracorporeal-support systems like hemodialysis might thus have mitigated beneficial effects of the MARS system in acute hepatic failure.
  
  
  METHODS
  We measured serum concentrations of IL-18 and Caspase-1 in 10 patients with acute liver failure and 10 patients suffering from acute-on-chronic-liver-failure, who were all treated with MARS. Thirteen patients suffering from chronic hepatic failure and 15 healthy individuals served as controls. Data are given as mean with 95% CI.
  
  
  RESULTS
  Baseline IL-18 serum concentrations were significantly increased in acute liver failure and acute-on-chronic-liver-failure patients as compared to chronic hepatic failure (P=0.0039 and P=0.0011, respectively) and controls (P=0.0028 and P=0.0014, respectively). Caspase-1 serum concentrations were as well significantly elevated in the acute liver failure and acute-on-chronic-liver-failure groups as compared to chronic hepatic failure patients (P=0.0039 and P=0.0232, respectively) and controls P<0.0001 and P<0.0007, respectively). IL-18 and Caspase-1 did not change significantly during MARS treatment in acute liver failure and acute-on-chronic-liver-failure patients.
  
  
  CONCLUSIONS
  MARS had no effect on IL-18 and Caspase-1 serum concentrations in acute liver failure and acute-on-chronic-liver-failure, providing no evidence of harmful effects by the increase of these potentially hepatocidal cytokines.
authors.affiliation: Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria. georg.roth@meduniwien.ac.at
authors.forename: G A
authors.initials: GA
authors.lastname: Roth
authors.forename: P
authors.initials: P
authors.lastname: Faybik
authors.forename: H
authors.initials: H
authors.lastname: Hetz
authors.forename: S
authors.initials: S
authors.lastname: Hacker
authors.forename: H J
authors.initials: HJ
authors.lastname: Ankersmit
authors.forename: A
authors.initials: A
authors.lastname: Bacher
authors.forename: T
authors.initials: T
authors.lastname: Thalhammer
authors.forename: C G
authors.initials: CG
authors.lastname: Krenn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020170:Caspase 1 / Q000097:blood*; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D017093:Liver Failure / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016060:Sorption Detoxification / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020382:Interleukin-18; D020170:Caspase 1