Abstract
BackgroundLiver cirrhosis is divided into two stages: compensated stage and another advanced stage which includes both decompensated cirrhosis and acute-on-chronic liver failure. The immune system is of major importance in cirrhosis pathophysiology. Sustained bacterial translocation from the intestine to systemic circulation causes a chronic systemic inflammatory syndrome. Inflammatory markers are emerging in the scope of cirrhosis and its complications due to their deleterious effects on disease progression and prognosis. The aim of the study was to assess the value of leukotriene B4 (LTB4) as a marker of decompensated cirrhosis and to evaluate its relation to disease progression and complications.ResultsThe current study was conducted on 80 candidates in the Alexandria Main University Hospital, Tropical Medicine Department; they were categorized into three groups: group I (n = 30) compensated cirrhotic patients, group II (n = 30) decompensated cirrhotic patients, and group III (n = 20) apparently healthy individuals. Serum LTB4 was measured by ELISA. LTB4 showed statistically significant higher values in the decompensated group than the compensated group (p = 0.007) and the control group (p = 0.002). However, there was no statistically significant difference between the compensated group and the controls (p = 0.510). LTB4 correlated positively with the Child-Pugh score (p = 0.003). Moreover, it correlated positively with the MELD-Na score (p = 0.012). There was a significant correlation between the degree of ascites and serum LTB4 (p < 0.001). However, there was no significant correlation between hepatic encephalopathy and LTB4 (P > 0.204).ConclusionSerum LTB4 could be used as a sensitive biomarker of decompensation in cirrhotic patients.
Highlights
Liver cirrhosis is divided into two stages: compensated stage and another advanced stage which includes both decompensated cirrhosis and acute-on-chronic liver failure
Our concepts on the pathophysiology of cirrhosis progression have undergone major changes and the axis formed by the bowel, liver, and immune system became of major importance [4]
Subjects This study was conducted on 80 candidates in the Alexandria Main University Hospital, Tropical Medicine Department; subjects were divided into three groups: group I (n = 30) compensated cirrhotic patients, group II (n = 30) decompensated cirrhotic patients, and group III (n = 20) apparently healthy individuals
Summary
Liver cirrhosis is divided into two stages: compensated stage and another advanced stage which includes both decompensated cirrhosis and acute-on-chronic liver failure. Sustained bacterial translocation from the intestine to systemic circulation causes a chronic systemic inflammatory syndrome. Inflammatory markers are emerging in the scope of cirrhosis and its complications due to their deleterious effects on disease progression and prognosis. The aim of the study was to assess the value of leukotriene B4 (LTB4) as a marker of decompensated cirrhosis and to evaluate its relation to disease progression and complications. Progression of a compensated stage to a decompensated one has a significantly negative effect. Our concepts on the pathophysiology of cirrhosis progression have undergone major changes and the axis formed by the bowel, liver, and immune system became of major importance [4]. Sustained bacterial translocation from the intestinal lumen to the systemic circulation and organs triggers the innate immune system and results in a chronic systemic inflammatory syndrome which may be a mechanism for decompensation and multiorgan dysfunction [5]. Leukotriene B4 role in decompensated cirrhosis has not been studied in depth
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