Abstract:

Objective To observe the changes of serum cytokine levels in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure(ACLF), and investigate the role of cytokines in the prognosis of HBV-related ACLF. Methods A total of 24 HBV-related ACLF patients(13 cured cases and 11 dead cases), 30 patients with chronic hepatitis B(CHB) and 15 healthy controls were enrolled. The serum levels of interleukin(IL)-2, IL-4, IL-6, IL-8, IL-10, granulocyte-macrophage colony stimulating factor(GM-CSF), gamma interferon (IFN-γ) and tumor necrosis factor alpha(TNF-α) were detected by Luminex liquid chip technology, and the relative Results were analyzed. Results The levels of IL-6, IL-8 and TNF-α in ACLF group were higher than those in CHB group and healthy control group (P<0.01), and those in CHB group were higher than those in healthy control group (P<0.05). IL-6, TNF-α and model for end stage liver disease (MELD) score in ACLF dead group were significantly higher than those in ACLF cured group(P<0.05). The levels of TNF-α and IL-6 were negatively correlated with prothrombin activity(PTA)(r=－0.712, P<0.001; r=－0.521, P=0.009). Furthermore, the levels of TNF-α and IL-6 were positively correlated with MELD score(r=0.491, P<0.015; r=0.379, P=0.048). There was no correlation among cytokines, HBV DNA and hepatitis B surface antigen(HBsAg). Results In HBV-related ACLF patients, various serum cytokines increase significantly. Furthermore, the levels of IL-6 and TNF-α increase with the severity of disease, and they are helpful in disease progression and prognosis.

Key words: Cytokine, Interleukin 6, Tumor necrosis factor alpha, Acute-on-chronic liver failure