Study of serum tumor necrosis factor-α in patients with liver cirrhosis

Abstract

Objective This study is designed to evaluate the serum level of tumor necrosis factor-α (TNF-a) in patients with liver cirrhosis and determine the possible relation between TNF-α and various complications of liver cirrhosis. Background TNF is a pleiotropic cytokine, mainly produced by monocytes and macrophages and implicated in several physiological and pathological conditions. Several studies have shown that serum levels of TNF-α are significantly elevated in patients with liver diseases. Patients and methods This study was conducted on 70 cirrhotic patients (group I) who were divided into three subgroups according to the Child-Pugh scoring system: group Ia comprised 15 patients with Child A; group Ib comprised 15 patients with Child B; and group Ic comprised 40 patients with Child C. The study also included 10 healthy controls (group II). The serum level of TNF-α was evaluated in all patients. Results A highly significant increase in the mean value of serum TNF-a was found in the liver cirrhosis group with significant positive correlation between serum level of TNF-α and Child-Pugh score. There was a highly significant increase in the mean value of serum TNF-α in encephalopathic patients in comparison with nonencephalopathic patients in the cirrhotic subgroups, with significant positive correlation between clinical grades of hepatic encephalopathy (HE) and TNF-α. Serum TNF-α was the only independent predictor for the development of HE. Conclusion Serum levels of TNF-α correlate positively with the severity of hepatic dysfunction and with the severity of HE in patients with liver cirrhosis. TNF-α may be a possible mediator in the pathogenesis of HE in cirrhotic patients.