title: TH-1 and TH-2 cytokines in stable chronic alcoholics.
abstract: In alcoholics, the activation of Kupffer cells by gram negative bacteriae leads to an inflammatory response and cytokine secretion, which in turn activate T-lymphocytes. Possibly, Th-1 lymphocytes are activated first, followed by a Th-2 response. Th-2 cytokines, especially interleukin (IL)-13 (scarcely studied in alcoholics), may be involved in the progression to chronic stages.
  
  
  OBJECTIVE
  The aim of the study was to analyze the relationship of Th-1 and Th-2 cytokines with liver function, alcohol consumption, nutritional status and survival.
  
  
  METHODS
  Serum Th-1 [interferon-γ (IFN-γ)] and Th-2 cytokines (IL-4, IL-13), IL-10, IL-6 and tumor necrosis factor (TNF-α), were determined for 18 controls and 47 stable alcoholics with variable liver function impairment, who were followed-up during a median time of 90 months, a period during which 14 patients died.
  
  
  RESULTS
  IL-4 was lower among patients; no differences were observed regarding IL-6, but the remaining ILs were higher among alcoholics. IL-10 and IL-13 were even higher in cirrhotics (Z = 2.88, P = 0.004, and Z = 2.09, P = 0.037, respectively). A significant, direct, correlation was observed between IL-13 and IL-10 (ρ = 0.49, P = 0.001), and non-significant, inverse ones were observed between IFN-γ and IL-13 (ρ = -0.23), IL-4 (ρ = -0.14) and IL-10 (ρ = -0.09). IL-13 and IL-10 were inversely related with liver function and, directly with immunoglobulin A levels, but not with survival.
  
  
  CONCLUSIONS
  Serum IFN-γ values were increased in alcoholics, who also showed raised IL-13 and IL-10, but lower IL-4 levels. Given the immunomodulatory roles of IL-10 and IL-13, this increase may be interpreted as a compensatory rise of anti-inflammatory cytokines. We failed to find any relation with mortality.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario, Ofra s/n, Tenerife, Canary Islands, Spain. egonrey@ull.es
authors.forename: E
authors.initials: E
authors.lastname: González-Reimers
authors.forename: F
authors.initials: F
authors.lastname: Santolaria-Fernández
authors.forename: J A
authors.initials: JA
authors.lastname: Medina-García
authors.forename: J M
authors.initials: JM
authors.lastname: González-Pérez
authors.forename: M J
authors.initials: MJ
authors.lastname: de la Vega-Prieto
authors.forename: L
authors.initials: L
authors.lastname: Medina-Vega
authors.forename: C
authors.initials: C
authors.lastname: Martín-González
authors.forename: M C
authors.initials: MC
authors.lastname: Durán-Castellón
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000097:blood* / Q000150:complications / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008099:Liver / Q000503:physiopathology*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma