Ascitic Fluid Interleukin-8 to Distinguish Spontaneous Bacterial Peritonitis and Sterile Ascites in Cirrhotic Patients

Abstract

Spontaneous bacterial peritonitis (SBP) is a common and potentially fatal complication of cirrhosis. The pathogenesis of spontaneous ascitic fluid infection appears to involve translocation of bacteria from the gut to the mesenteric lymph nodes, depressed reticuloendothelial phagocytic activity, and deficient ascitic fluid antibacterial activity. A high index of suspicion of this infection and a low threshold for performing an abdominal paracentesis are required to detect infection early, when survival is most likely (1). Interleukin-8 (IL-8) is a cytokine produced by a variety of cells in response to stimuli, such as bacterial lipopolysaccharide, with a strong chemotactic activity on neutrophils. Increased plasma IL-8 has been observed in patients with severe infections as well as in alcoholic and nonalcoholic cirrhotic patients (2)(3). To our knowledge, IL-8 production in ascitic fluid in cirrhotic patients developing SBP has not been determined. The aim of this study was to evaluate (a) IL-8 production in both plasma and ascitic …