Bernd Kronenberger, Ina Rudloff, Malte Bachmann, Friederike Brunner, Lisa Kapper, Natalie Filmann, Oliver Waidmann, Eva Herrmann, Josef Pfeilschifter, Stefan Zeuzem, Albrecht Piiper, Heiko Mühl
- Background: 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.
Methods: 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.
Results: 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 (P <0.001). Elevated levels of IL-22 were associated with ascites (P = 0.006), hepatorenal syndrome (P <0.0001), and spontaneous bacterial peritonitis (P = 0.001). Patients with elevated IL-22 (>18 pg/ml, n = 57) showed significantly reduced survival compared to patients with regular ([less than or equal to]18 pg/ml) levels of IL-22 (321 days versus 526 days, P = 0.003). Other factors associated with overall survival were high CRP ([greater than or equal to]2.9 mg/dl, P = 0.005, hazard ratio (HR) 0.314, confidence interval (CI) (0.141 to 0.702)), elevated serum creatinine (P = 0.05, HR 0.453, CI (0.203 to 1.012)), presence of liver-related complications (P = 0.028, HR 0.258 CI (0.077 to 0.862)), model of end stage liver disease (MELD) score [greater than or equal to]20 (P = 0.017, HR 0.364, CI (0.159 to 0.835)) and age (P = 0.011, HR 1.047, CI (1.011 to 1.085)). Adjusted multivariate Cox proportional-hazards analysis identified elevated systemic IL-22 levels as independent predictors of reduced survival (P = 0.007, HR 0.218, CI (0.072 to 0.662)).
Conclusions: 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.
MetadatenAuthor: | Bernd KronenbergerORCiDGND, Ina RudloffGND, Malte BachmannGND, Friederike Brunner, Lisa Kapper, Natalie FilmannORCiDGND, Oliver WaidmannORCiDGND, Eva HerrmannORCiDGND, Josef PfeilschifterGND, Stefan ZeuzemORCiDGND, Albrecht PiiperORCiD, Heiko MühlORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-263362 |
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DOI: | https://doi.org/10.1186/1741-7015-10-102 |
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ISSN: | 1741-7015 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/22967278 |
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Parent Title (English): | BMC medicine |
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Publisher: | London |
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Place of publication: | BioMed Central |
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Document Type: | Article |
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Language: | English |
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Year of Completion: | 2012 |
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Date of first Publication: | 2012/09/11 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2013/01/25 |
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Tag: | Alcoholic liver disease; Hepatitis; Interleukin-22; Liver cirrhosis; Liver-related complications; MELD |
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Volume: | 10 |
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Issue: | 102 |
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Page Number: | 11 |
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Note: | © 2012 Kronenberger et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
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HeBIS-PPN: | 319139115 |
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Institutes: | Biochemie, Chemie und Pharmazie / Pharmazie |
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| Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 2.0 |
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