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Circulating CXCL 10 in cirrhotic portal hypertension might reflect systemic inflammation and predict ACLF and mortality
Author(s) -
Lehmann Jennifer M.,
Claus Karina,
Jansen Christian,
Pohlmann Alessandra,
Schierwagen Robert,
Meyer Carsten,
Thomas Daniel,
Manekeller Steffen,
Claria Joan,
Strassburg Christian P.,
Trautwein Christian,
Wasmuth Hermann E.,
Berres MarieLuise,
Trebicka Jonel
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13610
Subject(s) - cirrhosis , medicine , decompensation , portal hypertension , ascites , gastroenterology , inflammation , hepatic encephalopathy , transjugular intrahepatic portosystemic shunt , portal venous pressure , systemic inflammation
Abstract Background & Aims CXCR % ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL 9 and CXCL 11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt ( TIPS ), the role of CXCL 10 in severe portal hypertension remains unknown. Methods A total of 89 cirrhotic patients were analysed. CXCL 10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients. CXCL 10 and IL 8 levels were assessed in portal, hepatic, cubital vein and right atrium blood in a further 25 patients at TIPS insertion. Furthermore, real‐time PCR determined hepatic CXCL 10‐ mRNA in 40 cirrhotic patients. Results Hepatic CXCL 10 showed no association with decompensation. By contrast, circulating CXCL 10‐levels were higher in portal than in hepatic vein blood, suggesting an extrahepatic source of CXCL 10 in cirrhosis. However, CXCL 10 protein in blood samples from portal, hepatic, cubital veins and right atrium correlated excellently with each other and with IL ‐8 levels. Higher CXCL 10 circulating levels were associated with presence of ascites and higher Child scores. Higher CXCL 10 circulating protein levels were associated with acute decompensation, acute‐on‐chronic liver failure ( ACLF ) and independently with mortality. Moreover, a decrease in CXCL 10 protein levels after TIPS insertion was associated with better survival in each cohort and analysed together. Discussion Circulating CXCL 10 possibly reflects systemic inflammation and it is correlated with acute decompensation, ACLF and complications in patients with severe portal hypertension receiving TIPS . CXCL 10 predicts survival in these patients and a decrease in CXCL 10 after TIPS may be considered a good prognostic factor.