The imbalance of peripheral interleukin-18 and transforming growth factor-β1 levels in patients with cirrhosis and esophageal varices. (January 2019)

• Record Type: Journal Article
• Authors: Swidnicka-Siergiejko, Agnieszka; Wereszczynska-Siemiatkowska, Urszula; Siemiatkowski, Andrzej; Wasielica-Berger, Justyna; Janica, Jacek; Mroczko, Barbara; Dabrowski, Andrzej
• Is Part Of: Cytokine. Volume 113(2019)
• Page Start: 440
• Page End: 445
• Publication Date: 2019-01
• Subjects: PH portal hypertension -- HSCs hepatic stellate cells -- KCs Kupffer cells -- NO nitric oxide -- ET-1 endothelin-1 -- TGF-β1 transforming growth factor-β1 -- IL-1β interleukin-1β -- TNF- α tumor necrosis factor-α -- IL-18 interleukin-18 -- MELD Model for End Stage Liver Disease -- HBV hepatitis B virus -- HCV hepatitis C virus -- TRL4 toll-like receptor 4 -- LPS lipopolysaccharide; Cirrhosis -- Esophageal varices -- Interleukin-18 -- Transforming growth factor beta1; Cytokines -- Periodicals; 571.844
• DOI: 10.1016/j.cyto.2018.10.024
• Languages: English
• ISSNs: 1043-4666

Abstract

Highlights: Cirrhotics with esophageal varices have an imbalance of IL-18 and TGF-β1 levels. Peripheral IL-18 and TGF-β1 levels correlate with liver failure indicators. Peripheral Il-18 levels decrease with beta-blocker therapy. Peripheral IL-18 levels can be a marker of clinically significant portal hypertension. Abstract: Introduction: The presence of esophageal varices in liver cirrhosis indicates clinically significant portal hypertension (PH), that results from structural and dynamic changes in the liver and systemic circulation including the activation of several fibrotic and inflammatory pathways. We assessed if interleukin-18 (IL-18) and transforming growth factor-β1 (TGF-β1) serum levels can be used as PH markers and reflect its severity. Material and methods: IL-18 and TGF-β1 peripheral blood levels were analyzed in 83 cirrhotic patients with esophageal varices compared to healthy individuals, in relation to MELD and Child-Pugh scores, laboratory and Doppler ultrasound parameters, and non-selective beta-blocker therapy (NSBB). Results: IL-18 concentration was significantly higher in cirrhotic patients, while TGF-β1 concentration was lower than in controls. MELD score correlated positively with IL-18 levels and negatively with TGF-β1 levels. IL-18 levels correlated positively with bilirubin, INR, ALT and AST levels, and negatively with albumin levels and erythrocyte count. TGF-β1 levels correlated positively with platelet count, leukocyte, and erythrocyte count, and negatively with bilirubin levels and prothrombin time. Moreover, significant correlations were found: between IL and 18 levels and portal, mesenteric superior, and splenic vein velocity, and between TGF-β1 levels and splenic vein diameter and spleen size. In a subgroup of patients, IL-18 levels significantly decreased after NSBB. Conclusion: The observed imbalance of peripheral IL-18 and TGF-β1 levels indicates clinically significant PH associated with the presence of esophageal varices in cirrhosis. The correlation of IL-18 levels with liver failure indicators and decrease with NSBB suggest an important role of IL-18 in disease progression and its potential use as noninvasive test for PH assessment.