OBJECTIVES: Inflammation may be implicated in the haemodynamic deterioration and in the development of complications in patients with cirrhosis. High-sensitivity C-reactive protein (hsCRP) is a marker of low-grade inflammation, and predicts outcomes in patients at risk of ischaemic heart disease. Proinflammatory cytokines reflect immune activation and have been found to be elevated in cirrhosis. We investigated a possible association between markers of inflammation and splanchnic and systemic haemodynamics, complications and survival in patients with cirrhosis. METHODS: In 45 stable patients with cirrhosis on the basis of alcohol consumption, we measured hsCRP, as well as monocyte chemoattractant protein-1, tumour necrosis factor-α, interleukin-6, interleukin-8 and vascular endothelial growth factor in patients and in 12 healthy controls. Systemic and splanchnic haemodynamics were investigated in patients. RESULTS: hsCRP levels were significantly higher in patients compared with controls (P<0.05) and the highest in patients belonging to Child-Pugh class C. hsCRP levels correlated with markers of liver dysfunction and with the hepatic venous pressure gradient (r=0.48, P<0.001). hsCRP values above the median level of 5.3 mg/l were associated with a highly increased mortality (P=0.001). Model for End-Stage Liver Disease score (P=0.01) and hsCRP (P<0.05) provided independent prognostic information. Cytokines had no discernible value in predicting survival. CONCLUSION: hsCRP is elevated in patients with cirrhosis and is associated with portal hypertension and decreased survival. hsCRP is a promising prognostic marker in cirrhosis, which may improve the selection of candidates for liver transplantation.
OBJECTIVES:Inflammation may be implicated in the haemodynamic deterioration and in the development of complications in patients with cirrhosis. High-sensitivity C-reactive protein (hsCRP) is a marker of low-grade inflammation, and predicts outcomes in patients at risk of ischaemic heart disease. Proinflammatory cytokines reflect immune activation and have been found to be elevated in cirrhosis. We investigated a possible association between markers of inflammation and splanchnic and systemic haemodynamics, complications and survival in patients with cirrhosis. METHODS: In 45 stable patients with cirrhosis on the basis of alcohol consumption, we measured hsCRP, as well as monocyte chemoattractant protein-1, tumour necrosis factor-α, interleukin-6, interleukin-8 and vascular endothelial growth factor in patients and in 12 healthy controls. Systemic and splanchnic haemodynamics were investigated in patients. RESULTS: hsCRP levels were significantly higher in patients compared with controls (P<0.05) and the highest in patients belonging to Child-Pugh class C. hsCRP levels correlated with markers of liver dysfunction and with the hepatic venous pressure gradient (r=0.48, P<0.001). hsCRP values above the median level of 5.3 mg/l were associated with a highly increased mortality (P=0.001). Model for End-Stage Liver Disease score (P=0.01) and hsCRP (P<0.05) provided independent prognostic information. Cytokines had no discernible value in predicting survival. CONCLUSION: hsCRP is elevated in patients with cirrhosis and is associated with portal hypertension and decreased survival. hsCRP is a promising prognostic marker in cirrhosis, which may improve the selection of candidates for liver transplantation.
Authors: Natalia Gnatienko; Matthew S Freiberg; Elena Blokhina; Tatiana Yaroslavtseva; Carly Bridden; Debbie M Cheng; Christine E Chaisson; Dmitry Lioznov; Sally Bendiks; Glory Koerbel; Sharon M Coleman; Evgeny Krupitsky; Jeffrey H Samet Journal: HIV Clin Trials Date: 2018-04-17
Authors: Manuela G Neuman; Yaakov Maor; Radu M Nanau; Ehud Melzer; Haim Mell; Mihai Opris; Lawrence Cohen; Stephen Malnick Journal: Biomolecules Date: 2015-08-28