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Title: Characterization of inflammatory response in acute-on-chronic liver failure and relationship with prognosis
Author: Solé, Cristina
Solà, Elsa
Morales Ruiz, Manuel
Fernàndez, Guerau
Huelin, Patricia
Graupera, Isabel
Moreira, Rebeca
de la Prada, Gloria
Ariza, Xavier
Pose, Elisa
Fabrellas i Padrès, Núria
Kalko, Susana
Jiménez Povedano, Wladimiro
Ginès i Gibert, Pere
Keywords: Inflamació
Insuficiència hepàtica
Malalties del fetge
Pronòstic mèdic
Cirrosi hepàtica
Liver failure
Liver diseases
Hepatic cirrhosis
Issue Date: 2016
Publisher: Nature Publishing Group
Abstract: ACLF is characterized by a systemic inflammatory response, but the cytokines involved in this process have not been well studied. The aim of this study was to characterize the systemic inflammatory response in patients with cirrhosis and ACLF and its relationship with prognosis. Fifty-five patients with cirrhosis, 26 with ACLF, were studied prospectively. Systemic inflammatory response was analyzed by measuring a large array of plasma cytokines by using a multiplex kit. A principal component analysis show noticeable differences between ACLF and decompensated cirrhosis without ACLF. Patients with ACLF had significant abnormal levels of 12 cytokines compared to those without ACLF, including: VCAM-1, VEGF-A, Fractalkine, MIP-1α, Eotaxin, IP-10, RANTES, GM-CSF, IL-1β, IL-2, ICAM-1, and MCP-1. Cytokines showing the most marked relationship with ACLF were VCAM-1 and VEGF-A (AUCROC 0.77; p = 0.001). There was a significant relationship between some of inflammatory mediators and 3-month mortality, particularly VCAM-1, ICAM-1, and GM-CSF (AUCROC>0.7; p < 0.05). Functional Enrichment Analysis showed that inflammatory markers differentially expressed in ACLF patients were enriched in leukocyte migration, particularly monocytes and macrophages, and chemotaxis pathways. In conclusion, ACLF is characterized by a marked inflammatory reaction with activation of mediators of adhesion and migration of leukocytes. The intensity of the inflammatory reaction correlates with prognosis.
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It is part of: Scientific Reports, 2016, vol. 6, p. 32341
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ISSN: 2045-2322
Appears in Collections:Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Biomedicina)
Articles publicats en revistes (Medicina)

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