Study of serum tumor necrosis factor-α in patients with liver cirrhosis

ObjectiveThis study is designed to evaluate the serum level of tumor necrosis factor-α (TNF-a) in patients with liver cirrhosis and determine the possible relation between TNF-α and various complications of liver cirrhosis.BackgroundTNF is a pleiotropic cytokine, mainly produced by monocytes and macrophages and implicated in several physiological and pathological conditions. Several studies have shown that serum levels of TNF-α are significantly elevated in patients with liver diseases.Patients and methodsThis study was conducted on 70 cirrhotic patients (group I) who were divided into three subgroups according to the Child-Pugh scoring system: group Ia comprised 15 patients with Child A; group Ib comprised 15 patients with Child B; and group Ic comprised 40 patients with Child C. The study also included 10 healthy controls (group II). The serum level of TNF-α was evaluated in all patients.ResultsA highly significant increase in the mean value of serum TNF-a was found in the liver cirrhosis group with significant positive correlation between serum level of TNF-α and Child-Pugh score. There was a highly significant increase in the mean value of serum TNF-α in encephalopathic patients in comparison with nonencephalopathic patients in the cirrhotic subgroups, with significant positive correlation between clinical grades of hepatic encephalopathy (HE) and TNF-α. Serum TNF-α was the only independent predictor for the development of HE.ConclusionSerum levels of TNF-α correlate positively with the severity of hepatic dysfunction and with the severity of HE in patients with liver cirrhosis. TNF-α may be a possible mediator in the pathogenesis of HE in cirrhotic patients.