Research on the relationship between serum cytokine levels and prognosis in patients with HBV-related acute-on-chronic liver failure

Objective To observe the changes of serum cytokine levels in patients with hepatitis B virus( HBV)-related acute-on-chronic liver failure( ACLF),and investigate the role of cytokines in the prognosis of HBV-related ACLF. Methods A total of 24 HBV-related ACLF patients( 13 cured cases and 11 dead cases),30 patients with chronic hepatitis B( CHB) and 15 healthy controls were enrolled. The serum levels of interleukin( IL)-2,IL-4,IL-6, IL-8,IL-10,granulocyte-macrophage colony stimulating factor( GM-CSF),gamma interferon( IFN-γ) and tumor necrosis factor alpha( TNF-α) were detected by Luminex liquid chip technology,and the relative results were analyzed. Results The levels of IL-6,IL-8 and TNF-α in ACLF group were higher than those in CHB group and healthy control group( P 0. 01),and those in CHB group were higher than those in healthy control group( P 0. 05). IL-6,TNF-α and model for end stage liver disease( MELD) score in ACLF dead group were significantly higher than those in ACLF cured group( P 0. 05). The levels of TNF-α and IL-6 were negatively correlated with prothrombin activity( PTA)( r =- 0. 712,P 0. 001; r =- 0. 521,P = 0. 009). Furthermore,the levels of TNF-α and IL-6 were positively correlated with MELD score( r = 0. 491,P 0. 015; r = 0. 379,P = 0. 048). There was no correlation among cytokines,HBV DNA and hepatitis B surface antigen( HBsAg). Conclusions In HBV-related ACLF patients,various serum cytokines increase significantly. Furthermore,the levels of IL-6 and TNF-α increase with the severity of disease,and they are helpful in disease progression and prognosis.