title: Diagnostic utility of interferon gamma-induced protein 10 kDa in spontaneous bacterial peritonitis: single-center study.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) is an important cause of mortality and morbidity in cirrhotic patients with ascites. The diagnosis of SBP is mainly made on the basis of a polymorphonuclear leukocyte cell count exceeding 250/μl in ascitic fluid. However, this procedure is subjective. We aimed to evaluate serum and ascitic fluid interferon-γ-induced protein (IP-10) as accurate diagnostic markers for detecting SBP.
  
  
  METHODS
  A total of 425 consecutive patients with ascites were included. Serum and ascitic fluid of IP-10, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured using an enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Patients were divided into an SBP group, including 61 patients, and a non-SBP group, including 364 patients. Serum and ascitic IP-10 were significantly higher in SBP patients than in patients without SBP (1855±825 vs. 955±510 pg/ml; P<0.001 and 2160±994 vs. 1110±623 pg/ml; P<0.001), respectively. There was a significant increase in both serum and ascitic levels of TNF-α and IL-6 in SBP patients than in patients without SBP. At a cut-off value of 1915 pg/ml, serum IP-10 had 91% sensitivity and 89% specificity for detecting SBP (area under the curve: 0.912). Also, at a cut-off value of 2355 pg/ml, ascitic IP-10 had 92.5% sensitivity and 87% specificity for detecting SBP (area under the curve: 0.943). Both were correlated with ascitic fluid proteins, polymorphonuclear count, TNF-α, and IL-6.
  
  
  CONCLUSIONS
  Serum and ascitic IP-10, TNF-α, and IL-6 are significantly increased in SBP patients versus patients without SBP. Serum level of IP-10 is more specific and sensitive, such as ascites. Thus, it seems to represent a satisfactory diagnostic marker for the diagnosis of SBP.
authors.affiliation: Departments of aTropical Medicine bInternal Medicine, Faculty of Medicine cClinical Pathology dMedical Microbiology and Immunology, Mansoura University, Mansoura eDepartment of Endemic Diseases and Gastroenterology, Aswan University, Aswan, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Razik
authors.forename: Nasser
authors.initials: N
authors.lastname: Mousa
authors.forename: Sherif
authors.initials: S
authors.lastname: Elbaz
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eissa
authors.forename: Rania
authors.initials: R
authors.lastname: Elhelaly
authors.forename: Waleed
authors.initials: W
authors.lastname: Eldars
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001202:Ascitic Fluid / Q000276:immunology / Q000378:metabolism; D001424:Bacterial Infections / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D054357:Chemokine CXCL10 / Q000097:blood*; D004534:Egypt; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha