title: Macrophage activation is a prognostic parameter for variceal bleeding and overall survival in patients with liver cirrhosis.
abstract: OBJECTIVE
  Soluble CD163 (sCD163) is shed in the blood circulation by activated macrophages, correlates strongly with the hepatic venous pressure gradient (HVPG) and is thereby a good indicator of portal hypertension. It is unknown whether sCD163 correlates with the risk of variceal bleeding and overall survival (OS) in patients with liver cirrhosis. We performed a prospective study to investigate if sCD163 serum levels correlate with the risk of variceal bleeding and OS in cirrhotic patients.
  
  
  METHODS
  Patients with liver cirrhosis were prospectively enrolled and followed until death or last contact. At the day of inclusion in the study, blood samples were taken and sCD163 serum levels were assessed by ELISA (enzyme-linked immunosorbent assay). The time until the end points death and variceal bleeding was assessed and the risks of death or variceal bleeding were calculated with uni- and multivariate Cox regression analyses.
  
  
  RESULTS
  High sCD163 levels (>4100 ng/L) were associated with death independently of the MELD (model of end stage liver disease) score, CRP (C-reactive protein), age and gender. Furthermore, high sCD163 levels were associated with gastrointestinal bleeding independently of the variceal stage and red spots.
  
  
  CONCLUSIONS
  The sCD163 serum level is a new independent non-invasive risk factor for death and variceal bleeding in cirrhotic patients.
authors: Medizinische Klinik 1, Schwerpunkt Gastroenterologie und Hepatologie, Klinikum der Goethe-Universität, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany. waidmann@biochem2.uni-frankfurt.de
authors: Oliver
authors: O
authors: Waidmann
authors: Friederike
authors: F
authors: Brunner
authors: Eva
authors: E
authors: Herrmann
authors: Stefan
authors: S
authors: Zeuzem
authors: Albrecht
authors: A
authors: Piiper
authors: Bernd
authors: B
authors: Kronenberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality*; D008262:Macrophage Activation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011956:Receptors, Cell Surface / Q000097:blood; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D000098902:CD163 Antigen
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D000098902:CD163 Antigen; D011956:Receptors, Cell Surface