Revista espanola de enfermedades digestivas · 2026
Characterization of the stages of chronic liver disease based on plasma proteins involved in systemic inflammation.
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Fortuny Marta, Torner Maria, Bermúdez-Ramos María, Ardèvol Alba, Morales Cristian, Bartolí Ramón, Morillas Rosa M, Domènech Eugeni, Sarrias Maria Rosa, Masnou Helena
Аннотация
INTRODUCTION: Cirrhosis is characterized by progressive fibrosis, portal hypertension, and cirrhosis-associated immune dysfunction, combining systemic inflammation and immunodeficiency. Although systemic inflammation plays a central role in disease progression and complications, current prognostic scores do not incorporate inflammatory biomarkers. This study aimed to characterize stages of chronic liver disease (CLD) according to a panel of plasma proteins involved in systemic inflammation in patients with and without bacterial infection.
MATERIALS AND METHODS: Patients with CLD were classified according to clinical stages of cirrhosis and assigned to NON-INFECTION or INFECTION cohort. Baseline characteristics and routine inflammatory parameters such as CRP, IL-6, procalcitonin and MDW were evaluated. Additional plasma biomarkers related with systemic inflammation and fibrosis (S100A8/S100A9, copeptin, CD5L, sCD14, sCD163) were quantified by ELISA.
RESULTS: Eighty-three patients were included in the NON-INFECTION cohort and 21 in the INFECTION cohort. In infection-free patients, CRP, IL-6, procalcitonin, MDW, and sCD163 increased progressively across disease stages, with significant differences between compensated and decompensated cirrhosis. Elevated inflammatory markers were observed even in early stages. Strong correlations (r>0.7) were identified between CRP and IL-6, particularly in advanced stages. In infected patients, CRP, procalcitonin, IL-6, and S100A8/S100A9 decreased significantly after infection resolution. However, inflammatory biomarkers frequently remained above normal ranges despite clinical resolution.
CONCLUSION: Systemic inflammation biomarkers increase progressively with cirrhosis severity and remain elevated even in the absence of infection, complicating diagnostic interpretation. Selected biomarkers, particularly CRP, IL-6, procalcitonin, and S100A8/S100A9, may help characterize infection-related inflammatory changes in patients with chronic liver disease. However, their clinical utility requires validation in larger independent cohorts.
MATERIALS AND METHODS: Patients with CLD were classified according to clinical stages of cirrhosis and assigned to NON-INFECTION or INFECTION cohort. Baseline characteristics and routine inflammatory parameters such as CRP, IL-6, procalcitonin and MDW were evaluated. Additional plasma biomarkers related with systemic inflammation and fibrosis (S100A8/S100A9, copeptin, CD5L, sCD14, sCD163) were quantified by ELISA.
RESULTS: Eighty-three patients were included in the NON-INFECTION cohort and 21 in the INFECTION cohort. In infection-free patients, CRP, IL-6, procalcitonin, MDW, and sCD163 increased progressively across disease stages, with significant differences between compensated and decompensated cirrhosis. Elevated inflammatory markers were observed even in early stages. Strong correlations (r>0.7) were identified between CRP and IL-6, particularly in advanced stages. In infected patients, CRP, procalcitonin, IL-6, and S100A8/S100A9 decreased significantly after infection resolution. However, inflammatory biomarkers frequently remained above normal ranges despite clinical resolution.
CONCLUSION: Systemic inflammation biomarkers increase progressively with cirrhosis severity and remain elevated even in the absence of infection, complicating diagnostic interpretation. Selected biomarkers, particularly CRP, IL-6, procalcitonin, and S100A8/S100A9, may help characterize infection-related inflammatory changes in patients with chronic liver disease. However, their clinical utility requires validation in larger independent cohorts.