[Pathogenetic importance of proinflammatory cytokines in the formation and progression of fibrosis in alcoholic hepatitis].

AIM OF INVESTIGATION: To study the effect of tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) on prognosis and outcome of alcoholic hepatitis (formation of fibrosis).

METHODS

Overall 48 patients with alcoholic hepatitis (AH) were investigated. The control group consisted of 25 healthy donors. Morphological study of liver biopsies and 13C-methacetin breath test (13C MBT) was carried out at 15 patients with AH. Concentration of TNF-alpha, IL-6 and C-reactive protein (CRP) in blood serum was detected by immunoenzyme assay with application of commercial tests-systems Vector-Best.

STUDY

RESULTS

At patients with AH TNF-alpha, IL-6 and CRP significantly increased in comparison to healthy persons. We found a significant correlation between fibrosis stage and TNF-alpha (r = 0.53; p < 0.01), IL-6 (r = 0.62; p < 0.01), the Knodell Histological Activity Index and TNF-alpha (r = 0.58, p < 0.05), IL-6 (r = 0.64; p < 0.01), the results of 13C MBT and TNF-alpha (r = -0.72; p < 0.01), IL-6 (r = -0.73; p < 0.01), alanine aminotransferase and TNF-alpha (r = 0.61; p < 0.01), IL-6 (r = 0.54; p < 0.01), aspartate aminotransferase and TNF-alpha (r = 0.64; p < 0.01), IL-6 (r = 0.65; p < 0.01), gamma-glutamyl transpeptidase and TNF-alpha (r = 0.46; p < 0.01), IL-6 (r = 0.48; p < 0.01).

CONCLUSIONS

Serum TNF-alpha and IL-6 have predictive value for development of inflammation and fibrosis in patients with AH and can be used as non-invasive markers of fibrosis.