Interleukin-1 receptor antagonist correlates with hepatic venous pressure gradient and predicts occurrence of overall complications and bacterial infections in patients with cirrhosis.
OBJECTIVE
The plasma levels of interleukin (IL)-1α, IL-1β and IL-1 receptor antagonist (IL-1Ra) are increased in cirrhotic patients. We aimed to investigate whether these cytokines correlate with hepatic venous pressure gradient (HVPG), the severity of liver cirrhosis and complications of cirrhosis.


METHODS
Sixty-three cirrhotic patients that underwent hemodynamic studies in Taipei Veterans General hospital were enrolled retrospectively. Plasma levels of IL-1α, IL-1β, IL-1Ra and endotoxin were assessed by enzyme-linked immunosorbent assay. Plasma obtained from 11 healthy subjects served as normal controls.


RESULTS
Plasma levels of IL-1α, IL-1β and IL-1Ra were increased in cirrhotic patients compared with controls. IL-1Ra levels significantly correlated with plasma endotoxin levels, Child-Pugh scores, Model of End-Stage Liver Disease (MELD) scores and HVPG. On multivariate analysis, higher IL-1Ra levels (≥760 pg/mL) predicted the occurrence of portal hypertension-related complications and the development of bacterial infections independently of the MELD scores and portal pressure. Furthermore, higher IL-1Ra levels also predicted the survival in patients without hepatocellular carcinoma.


CONCLUSIONS
The plasma IL-1Ra level correlates with HVPG. Additionally, it may predict the occurrence of portal hypertension-related complications and bacterial infections in cirrhotic patients and the survival in patients without hepatocellular carcinoma.
Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Yun-Cheng
YC
Hsieh
Kuei-Chuan
KC
Lee
Ying-Ying
YY
Yang
Teh-Ia
TI
Huo
Yi-Hsiang
YH
Huang
Han-Chieh
HC
Lin
bacterial infection; hepatic venous pressure gradient; interleukin-1 receptor antagonist; liver cirrhosis