interleukin-8 and Hypertension--Portal

Recent literature has supported the role of bacterial translocation as a mediator of splanchnic vasodilatation and portal hypertension. The objective of this study was to determine whether the probiotic VSL#3 would reduce portal pressure in patients with cirrhosis.. Eight patients with compensated or very early decompensated cirrhosis and hepatic venous pressure gradient (HVPG) >10 mmHg, received 2 months of VSL#3 (3600 billion bacteria daily). The HVPG, intestinal permeability, endotoxin, tumour necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-8, renin and aldosterone were measured at baseline and study end.. There was no change in the HVPG or intestinal permeability from baseline to study end but there was a trend to reduction in plasma endotoxin (P=0.09), a mild but significant increase in serum TNF-alpha (P=0.02) and a significant reduction in plasma aldosterone (P=0.03).. Within the limitations of small sample size, there does not appear to be a benefit of probiotic therapy for portal pressure reduction in patients with compensated or early decompensated cirrhosis. The reductions in endotoxin and aldosterone suggest possible beneficial effects of probiotics for this patient population. The clinical significance of the small but unexpected increase in TNF-alpha is unclear. Future studies are planned in patients with decompensated cirrhosis.

Topics: Aldosterone; Bacterial Translocation; Endotoxins; Female; Humans; Hypertension, Portal; Interleukin-6; Interleukin-8; Intestinal Mucosa; Intestines; Liver Cirrhosis; Male; Middle Aged; Permeability; Pilot Projects; Portal Pressure; Probiotics; Prospective Studies; Renin; Treatment Outcome; Tumor Necrosis Factor-alpha

The study aimed to explore the clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in treating cirrhotic portal hypertension and relevant influencing factors. 100 patients with cirrhotic portal hypertension receiving TIPS in the 980 hospitals of PLA logistic force from January 2015 to January 2018 were enrolled. Blood was collected from patients to detect liver function indicators [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)], renal function indicators [blood urea nitrogen (BUN) and creatinine (Cr)], glucose metabolism indicators [insulin and glucose (GLU)] and inflammatory factors [interleukin-6 (IL-6), IL-8 and CXCL9] before surgery and at1 and 6 month(s) after surgery. Surgical efficacy was evaluated. The physique of patients was examined. The portal venous pressure, diameter and hemorheological indicators of patients were measured. Additionally, postoperative complications and nursing satisfaction were observed. At 1 and 6 month(s) after an operation, the levels of AST, ALT, BUN, Cr, insulin, GLU and inflammatory factors IL-6, IL-8 and CXCL9 and the portal venous pressure were overtly reduced (p<0.05), the postoperative dry weight was increased (p<0.05), the postoperative nursing satisfaction was 97%, the patients with higher satisfaction had fewer complications (p<0.05), the diameter of the portal vein was notably lowered (p<0.05), while the blood flow rate was remarkably raised (p<0.05). After the application of TIPS in the treatment of cirrhotic portal hypertension, the liver function, renal function, glucose metabolism and portal venous pressure and flow rate of patients return to normal, and postoperative complications are clearly reduced after postoperative nursing, proving the overall efficacy. Hence, TIPS is worthy of popularization and application.

Topics: Glucose; Humans; Hypertension, Portal; Insulin; Interleukin-6; Interleukin-8; Liver Cirrhosis; Portasystemic Shunt, Transjugular Intrahepatic; Postoperative Complications; Retrospective Studies; Treatment Outcome

Alcoholic hepatitis (AH) is characterized by hepatocellular damage, inflammation, and fibrosis. We performed a prospective study to associate hepatic expression of the CXC subfamily of chemokines with histology findings and prognosis of patients with AH.. Liver biopsy samples from 105 patients with AH and 5 normal liver samples (controls) were evaluated for steatosis, inflammation, fibrosis, and cholestasis. Computer-based morphometric analysis assessed the numbers of infiltrating CD3+ T cells and CD15+ cells (neutrophils); terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling staining was used to quantify apoptosis. Expression of CXC and CC chemokines and selected signaling components were assessed by quantitative reverse-transcription polymerase chain reaction; protein levels of interleukin (IL)-8 and Gro-alpha also were determined by immunohistochemistry. Serum levels of IL-8 and Gro-alpha were measured by enzyme-linked immunosorbent assay. The Cox regression model identified variables associated with mortality.. Most patients (75%) had severe AH; their 90-day mortality rate was 21.9%. In AH liver samples, expression of the CXC subfamily members IL-8, Gro-alpha, CXCL5, CXCL6, CXCL10, and platelet factor 4 was up-regulated and compared with controls. The CC chemokine CCL2, but not CCL5, also was up-regulated. Higher expression levels of IL-8, CXCL5, Gro-gamma, and CXCL6 were associated with worse prognosis. Expression of CXC components correlated with neutrophil infiltration and the severity of portal hypertension. In the multivariate analysis, IL-8 protein levels were an independent predictor of 90-day mortality. IL-8 and Gro-alpha serum levels did not correlate with prognosis.. Hepatic expression of CXC components correlates with prognosis of patients with AH. Reagents that target CXC chemokines might be developed as therapeutics.

Topics: Apoptosis; Biopsy; Chemokine CXCL1; Chemokines, CXC; Female; Gene Expression; Hepatitis, Alcoholic; Humans; Hypertension, Portal; In Situ Nick-End Labeling; Interleukin-8; Liver; Male; Middle Aged; Prognosis; Survival Rate

The present study investigated plasma levels of interleukin-8 (IL-8) in patients with post-hepatitic cirrhosis and correlated it with the severity of liver diseases and haemodynamic parameters. Plasma IL-8 levels were significantly higher in 57 post-hepatitic cirrhotic patients (7.5 +/- 1.8 pg/mL; P < 0.005) than those in 41 healthy subjects (2.0 +/- 0.2 pg/mL). Elevated (> 5 pg/mL) plasma IL-8 levels were found in up to 30% of cirrhotic patients. In cirrhotic patients, plasma IL-8 levels progressively increased in relation to the severity of liver dysfunction (4.5 +/- 1.0, 4.9 +/- 1.4 and 20.5 +/- 8.3 pg/mL for Pugh's class A, B and C, respectively; P < 0.005). A significant correlation was observed between plasma IL-8 levels and serum bilirubin levels (r = 0.72; P < 0.001). There were no differences in the hepatic venous pressure gradient (15.4 +/- 1.1 vs 15.1 +/- 0.9 mmHg; P > 0.05) and systemic vascular resistance (1119 +/- 118 vs 1199 +/- 54 dyn.s/cm5; P > 0.05) between cirrhotic patients with and without elevated plasma IL-8 levels. In addition, plasma IL-8 levels did not correlate with hepatic venous pressure gradient (r = 0.26; P > 0.05) and systemic vascular resistance (r = -0.24; P > 0.05). These results demonstrate that plasma IL-8 levels are increased in patients with post-hepatitic cirrhosis. The severity of liver cirrhosis is an important factor for the occurrence of enhanced IL-8 levels. IL-8 does not play a role in the hyperdynamic circulation observed in patients with post-hepatitic cirrhosis.

Topics: Bilirubin; Female; Hepatitis B; Hepatitis C; Humans; Hypertension, Portal; Interleukin-8; Liver; Liver Circulation; Liver Cirrhosis; Male; Middle Aged; Vascular Resistance; Venous Pressure