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Corticosteroid might reduce serum levels of pro‐inflammatory cytokines in fulminant hepatitis: A case series
Author(s) -
Fujiwara Keiichi,
Hida Seiji,
Yasui Shin,
Yokosuka Osamu,
Oda Shigeto
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12906
Subject(s) - medicine , fulminant , cytokine , fulminant hepatic failure , tumor necrosis factor alpha , gastroenterology , liver transplantation , fulminant hepatitis , immunology , interleukin 6 , necrosis , stage (stratigraphy) , transplantation , hepatitis , paleontology , biology
Aim There are no beneficial therapies except for emergency liver transplantation for acute liver failure (ALF). However, in Japan, which has a serious problem in the shortage of donor livers, therapies other than transplantation must be further investigated for patients with ALF. Pro‐inflammatory cytokines promoting tissue destruction are predominant at an early phase of ALF. Corticosteroid (CS) influences monocyte/macrophage differentiation, by suppressing pro‐inflammatory genes, indicating CS treatment might be beneficial during the early phase of ALF. Our aim was to elucidate the efficacy of CS pulse therapy in decreasing pro‐inflammatory cytokine levels in the early stage of ALF. Methods Ten consecutive adult Japanese patients with fulminant hepatitis in the early stage, three treated with artificial liver support (ALS) and CS pulse therapy (ALS + CS group) and seven treated with ALS (ALS group), were enrolled. Clinical and biochemical data on admission were matched between the groups and retrospectively analyzed for serum concentrations of interleukin‐6, tumor necrosis factor‐α, and interleukin‐1β over a 2‐week period. Results Mean cytokine levels on admission were not different between the two groups. Tumor necrosis factor‐α was significantly reduced on day 7 in patients with CS. Serum levels of pro‐inflammatory cytokines tended to be reduced in patients with CS compared to those without during the observation period, although the differences were not significant. Conclusions It might be possible that introduction of CS pulse therapy in the early stage of ALF could reduce levels of pro‐inflammatory cytokines, which might inhibit the cascade of progression of ALF.