Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study
<p>Abstract</p> <p>Background</p> <p>Interleukin-22 (IL-22), recently identified as a crucial parameter of pathology in experimental liver damage, may determine survival in clinical end-stage liver disease. Systematic analysis of serum IL-22 in relation to morbidity and...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2012-09-01
|
Series: | BMC Medicine |
Subjects: | |
Online Access: | http://www.biomedcentral.com/1741-7015/10/102 |
id |
doaj-c6f38f8f0449482cb36fc11bba09e558 |
---|---|
record_format |
Article |
spelling |
doaj-c6f38f8f0449482cb36fc11bba09e5582020-11-25T01:03:37ZengBMCBMC Medicine1741-70152012-09-0110110210.1186/1741-7015-10-102Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort studyKronenberger BerndRudloff InaBachmann MalteBrunner FriederikeKapper LisaFilmann NatalieWaidmann OliverHerrmann EvaPfeilschifter JosefZeuzem StefanPiiper AlbrechtMühl Heiko<p>Abstract</p> <p>Background</p> <p>Interleukin-22 (IL-22), recently identified as a crucial parameter of pathology in experimental liver damage, may determine survival in clinical end-stage liver disease. Systematic analysis of serum IL-22 in relation to morbidity and mortality of patients with advanced liver cirrhosis has not been performed so far.</p> <p>Methods</p> <p>This is a prospective cohort study including 120 liver cirrhosis patients and 40 healthy donors to analyze systemic levels of IL-22 in relation to survival and hepatic complications.</p> <p>Results</p> <p>A total of 71% of patients displayed liver cirrhosis-related complications at study inclusion. A total of 23% of the patients died during a mean follow-up of 196 ± 165 days. Systemic IL-22 was detectable in 74% of patients but only in 10% of healthy donors (<it>P </it>< 0.001). Elevated levels of IL-22 were associated with ascites (<it>P </it>= 0.006), hepatorenal syndrome (<it>P </it>< 0.0001), and spontaneous bacterial peritonitis (<it>P </it>= 0.001). Patients with elevated IL-22 (>18 pg/ml, n = 57) showed significantly reduced survival compared to patients with regular (≤18 pg/ml) levels of IL-22 (321 days <it>versus </it>526 days, <it>P </it>= 0.003). Other factors associated with reduced overall survival were high CRP (≥2.9 mg/dl, <it>P </it>= 0.005, hazard ratio (HR) 0.314, confidence interval (CI) (0.141 to 0.702)), elevated serum creatinine (<it>P </it>= 0.05, HR 0.453, CI (0.203 to 1.012)), presence of liver-related complications (<it>P </it>= 0.028, HR 0.258, CI (0.077 to 0.862)), model of end stage liver disease (MELD) score ≥20 (<it>P </it>= 0.017, HR 0.364, CI (0.159 to 0.835)) and age (<it>P </it>= 0.011, HR 0.955, CI (0.922 to 0.989)). Adjusted multivariate Cox proportional-hazards analysis identified elevated systemic IL-22 levels as independent predictors of reduced survival (<it>P </it>= 0.007, HR 0.218, CI (0.072 to 0.662)).</p> <p>Conclusions</p> <p>In patients with liver cirrhosis, elevated systemic IL-22 levels are predictive for reduced survival independently from age, liver-related complications, CRP, creatinine and the MELD score. Thus, processes that lead to a rise in systemic interleukin-22 may be relevant for prognosis of advanced liver cirrhosis.</p> http://www.biomedcentral.com/1741-7015/10/102Interleukin-22Liver cirrhosisLiver-related complicationsHepatitisAlcoholic liver diseaseMELD |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kronenberger Bernd Rudloff Ina Bachmann Malte Brunner Friederike Kapper Lisa Filmann Natalie Waidmann Oliver Herrmann Eva Pfeilschifter Josef Zeuzem Stefan Piiper Albrecht Mühl Heiko |
spellingShingle |
Kronenberger Bernd Rudloff Ina Bachmann Malte Brunner Friederike Kapper Lisa Filmann Natalie Waidmann Oliver Herrmann Eva Pfeilschifter Josef Zeuzem Stefan Piiper Albrecht Mühl Heiko Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study BMC Medicine Interleukin-22 Liver cirrhosis Liver-related complications Hepatitis Alcoholic liver disease MELD |
author_facet |
Kronenberger Bernd Rudloff Ina Bachmann Malte Brunner Friederike Kapper Lisa Filmann Natalie Waidmann Oliver Herrmann Eva Pfeilschifter Josef Zeuzem Stefan Piiper Albrecht Mühl Heiko |
author_sort |
Kronenberger Bernd |
title |
Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
title_short |
Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
title_full |
Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
title_fullStr |
Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
title_full_unstemmed |
Interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
title_sort |
interleukin-22 predicts severity and death in advanced liver cirrhosis: a prospective cohort study |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2012-09-01 |
description |
<p>Abstract</p> <p>Background</p> <p>Interleukin-22 (IL-22), recently identified as a crucial parameter of pathology in experimental liver damage, may determine survival in clinical end-stage liver disease. Systematic analysis of serum IL-22 in relation to morbidity and mortality of patients with advanced liver cirrhosis has not been performed so far.</p> <p>Methods</p> <p>This is a prospective cohort study including 120 liver cirrhosis patients and 40 healthy donors to analyze systemic levels of IL-22 in relation to survival and hepatic complications.</p> <p>Results</p> <p>A total of 71% of patients displayed liver cirrhosis-related complications at study inclusion. A total of 23% of the patients died during a mean follow-up of 196 ± 165 days. Systemic IL-22 was detectable in 74% of patients but only in 10% of healthy donors (<it>P </it>< 0.001). Elevated levels of IL-22 were associated with ascites (<it>P </it>= 0.006), hepatorenal syndrome (<it>P </it>< 0.0001), and spontaneous bacterial peritonitis (<it>P </it>= 0.001). Patients with elevated IL-22 (>18 pg/ml, n = 57) showed significantly reduced survival compared to patients with regular (≤18 pg/ml) levels of IL-22 (321 days <it>versus </it>526 days, <it>P </it>= 0.003). Other factors associated with reduced overall survival were high CRP (≥2.9 mg/dl, <it>P </it>= 0.005, hazard ratio (HR) 0.314, confidence interval (CI) (0.141 to 0.702)), elevated serum creatinine (<it>P </it>= 0.05, HR 0.453, CI (0.203 to 1.012)), presence of liver-related complications (<it>P </it>= 0.028, HR 0.258, CI (0.077 to 0.862)), model of end stage liver disease (MELD) score ≥20 (<it>P </it>= 0.017, HR 0.364, CI (0.159 to 0.835)) and age (<it>P </it>= 0.011, HR 0.955, CI (0.922 to 0.989)). Adjusted multivariate Cox proportional-hazards analysis identified elevated systemic IL-22 levels as independent predictors of reduced survival (<it>P </it>= 0.007, HR 0.218, CI (0.072 to 0.662)).</p> <p>Conclusions</p> <p>In patients with liver cirrhosis, elevated systemic IL-22 levels are predictive for reduced survival independently from age, liver-related complications, CRP, creatinine and the MELD score. Thus, processes that lead to a rise in systemic interleukin-22 may be relevant for prognosis of advanced liver cirrhosis.</p> |
topic |
Interleukin-22 Liver cirrhosis Liver-related complications Hepatitis Alcoholic liver disease MELD |
url |
http://www.biomedcentral.com/1741-7015/10/102 |
work_keys_str_mv |
AT kronenbergerbernd interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT rudloffina interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT bachmannmalte interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT brunnerfriederike interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT kapperlisa interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT filmannnatalie interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT waidmannoliver interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT herrmanneva interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT pfeilschifterjosef interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT zeuzemstefan interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT piiperalbrecht interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy AT muhlheiko interleukin22predictsseverityanddeathinadvancedlivercirrhosisaprospectivecohortstudy |
_version_ |
1725200308289667072 |