title: The relation between pathogenesis of liver cirrhosis, hepatic encephalopathy and serum cytokine levels: what is the role of tumor necrosis factor α?
abstract: OBJECTIVE
  Hepatic encephalopathy (HE) is a major complication of acute or chronic liver disease characterized by neuropsychiatric symptoms. It's etiology and pathogenetical mechanisms are not clearly understood and probably it is multifactorial. In this study, we aimed to investigate the relation between pathogenesis of HE and TNF-alpha, IL-1beta, IL-2R, IL-6, IL-8 and IL-10, and between the severity of HE and the levels of these cytokines.
  
  
  METHODS
  Eighty patients with liver cirrhosis [50 patients with clinical findings of HE (group 1) and 30 without any symptoms of HE (group 2)] and 30 healthy controls (group 3) were included into the study. Serum TNF-alpha, IL-1beta, IL-2R, IL-6, IL-8 and IL-10 levels of patients and control subjects were studied with the chemiluminescent method.
  
  
  RESULTS
  There were statistically significant difference between serum TNF-alpha, IL-1beta, IL-2R, IL-6 and IL-8 levels of patients with liver cirrhosis and healthy subjects (p<0.05), and between patients with and without HE (p<0.05). There was a correlation between the severity of liver cirrhosis according to Child-Pugh classification and cytokine levels. The severity of HE (grade 1-4) was closely related with cytokine levels, especially TNF-a. On the other hand, there was no relation between cytokine levels and the etiological factors.
  
  
  CONCLUSIONS
  We found a positive correlation between serum inflammatory cytokine levels (TNF-alpha, IL-1beta, IL-2R, IL-6, IL-8) and the severity of liver cirrhosis. In addition, our findings suggested that this relation is independent from etiological factors.
authors.affiliation: Department of Gastroenterology, Dicle University School of Medicine, Diyarbakir, Turkey. vegoral@hotmail.com
authors.forename: Vedat
authors.initials: V
authors.lastname: Goral
authors.forename: Yahya
authors.initials: Y
authors.lastname: Atayan
authors.forename: Abdurahman
authors.initials: A
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology*
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha