title: Serum cytokeratin 18 and cytokine elevations suggest a high prevalence of occupational liver disease in highly exposed elastomer/polymer workers.
abstract: OBJECTIVE
  Cytokeratin 18 (CK18) is a novel serologic biomarker for occupational liver disease. The purpose of this study is to determine the prevalence of CK18 elevation in elastomer/polymer workers exposed to acrylonitrile, 1,3-butadiene, and styrene.
  
  
  METHODS
  A total of 82 chemical workers were evaluated. Cytokeratin 18 was determined by enzyme-linked immunosorbent assay and proinflammatory cytokines were measured by multi-analyte chemiluminescent detection.
  
  
  RESULTS
  Thirty-nine percent (32 of 82) had elevated CK18 levels, which were not explained by alcohol or obesity, except in potentially four cases. The pattern of CK18 elevation was consistent with toxicant-associated steatohepatitis (TASH) in the majority of cases (78%). Tumor necrosis factor α, interleukin-6, interleukin-8, monocyte chemotactic protein-1, and plasminogen activator inhibitor-1 were increased in these workers compared with those with normal CK18 levels.
  
  
  CONCLUSIONS
  These results suggest a high prevalence of occupational liver disease and TASH in elastomer/polymer workers with elevated proinflammatory cytokines.
authors.affiliation: Department of Medicine Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY 40202, USA. matt.cave@louisville.edu
authors.forename: Matt
authors.initials: M
authors.lastname: Cave
authors.forename: Keith Cameron
authors.initials: KC
authors.lastname: Falkner
authors.forename: Latasha
authors.initials: L
authors.lastname: Henry
authors.forename: Brittany
authors.initials: B
authors.lastname: Costello
authors.forename: Bonnie
authors.initials: B
authors.lastname: Gregory
authors.forename: Craig J
authors.initials: CJ
authors.lastname: McClain
mesh_terms: D000181:Acrylonitrile / Q000009:adverse effects*; D000328:Adult; D002070:Butadienes / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood*; D018932:Chemokine CCL2 / Q000097:blood; D016207:Cytokines / Q000097:blood*; D020724:Elastomers / Q000009:adverse effects; D005234:Fatty Liver / Q000097:blood* / Q000139:chemically induced; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D053538:Keratin-18 / Q000097:blood*; D016014:Linear Models; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood* / Q000139:chemically induced; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011108:Polymers / Q000009:adverse effects; D018709:Statistics, Nonparametric; D020058:Styrene / Q000009:adverse effects*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D002070:Butadienes; D018932:Chemokine CCL2; D016207:Cytokines; D020724:Elastomers; D007375:Interleukin-1; D015850:Interleukin-6; D053538:Keratin-18; D017395:Plasminogen Activator Inhibitor 1; D011108:Polymers; D014409:Tumor Necrosis Factor-alpha; D020058:Styrene; C031763:1,3-butadiene; D000181:Acrylonitrile