Correlation between interleukin-6 and ammonia in patients with overt hepatic encephalopathy due to cirrhosis.
OBJECTIVE
Previous studies have shown that elevated serum levels of interleukin-6 (IL-6) correlate with the severity of overt hepatic encephalopathy (OHE) in cirrhotic patients. However, the correlation between serum IL-6 levels and plasma ammonia levels in these patients remains unclear. Therefore, the present study investigated this correlation between both variables in cirrhotic patients with OHE.


METHODS
Fifty-five cirrhotic patients with various grades of OHE, 29 cirrhotic patients without OHE, and 30 healthy controls were recruited. Concentrations of plasma ammonia and serum IL-6 were simultaneously measured.


RESULTS
In cirrhotic patients with OHE, the severity of OHE, represented by the West Haven criteria, correlated with serum IL-6 levels (r=0.43, P<0.05) and plasma ammonia levels (r=0.59, P<0.05). IL-6 and ammonia were found to be significant independent predictors of OHE severity (P<0.05 for both variables). Furthermore, the severity of liver cirrhosis, determined by Child-Pugh scores, correlated with serum IL-6 levels (r=0.45, P<0.05) and plasma ammonia levels (r=0.68, P<0.05) in these patients. Moreover, there was a significant positive correlation between serum IL-6 levels and plasma ammonia levels (r=0.58, P<0.05) in cirrhotic patients with OHE, but not in patients without OHE (r=0.42, P>0.05) or healthy controls (r=0.27, P>0.05). The correlation between IL-6 and ammonia was independent of infectious precipitating factors.


CONCLUSIONS
The results of the present study suggest that IL-6 might be involved in the mechanism by which ammonia contributes to the pathogenesis of OHE. There is also evidence of a potential synergistic interaction between proinflammatory cytokines and ammonia in the pathogenesis of OHE.
Graduate School, Tianjin Medical University, No. 81 mailbox, 22, Qixiangtai Road, Heping District, 300070 Tianjin, China. romean@sina.com
Ming
M
Luo
Lei
L
Li
Er-Na
EN
Yang
Chen-Yang
CY
Dai
Shu-Ren
SR
Liang
Wu-Kui
WK
Cao
D000328:Adult; D000641:Ammonia / Q000097:blood*; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood* / Q000209:etiology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000502:physiology; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged
D015850:Interleukin-6; D000641:Ammonia