IL-6, TNF-α, IL-10, and nutritional status in pediatric patients with biliary atresia

Wilasco, Maria Inês de Albuquerque; Cruz, Carolina Uribe; Santetti, Daniele; Fries, Gabriel R.; Dornelles, Cristina; Silveira, Themis Reverbel da

doi:10.1016/j.jped.2016.11.009

Cited by 13 publications

(5 citation statements)

References 26 publications

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“…The absence of a close relationship between MUAC and inner body composition may be explained by the fact that infants with chronic liver disease are susceptible to changes in body composition [6,7]. Previous studies in children reported that the accuracy of MUAC in determining fat and muscle mass in the body was limited compared to CT or Magnetic Resonance Imaging [39,40].…”

Section: Discussionmentioning

confidence: 99%

“…Infants with chronic cholestatic liver disease are prone to malnutrition because of several factors: intestinal malabsorption of fat and fat-soluble vitamins, abnormalities in the metabolism of liver macronutrients' metabolic pathways, depression of hepatic plasma insulin-like growth factors, impeded nutritional intake because of discomfort because of ascites, cholestasis and/or organomegaly, and increased metabolic demands (6)(7)(8)(9). This multifactorial process can lead to neurodevelopmental delay, decreased bone mineralization, loss of muscle mass, and even to paradoxal increase of fat storage, making these infants prone to sarcopenia and sarcopenic obesity (10)(11)(12)(13)(14)(15).…”

Section: What Is Newmentioning

confidence: 99%

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Body Composition of Infants With Biliary Atresia

Grutters¹,

Pennings

Bruggink³

et al. 2020

J. pediatr. gastroenterol. nutr.

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Section: Discussionmentioning

confidence: 99%

Section: What Is Newmentioning

confidence: 99%

Body Composition of Infants With Biliary Atresia

Grutters¹,

Pennings

Bruggink³

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…Though current understanding for the neonatal population is modest, studies in adult and children show that critical illness changes metabolism significantly by decreasing the rate of absorption and utilization of nutrients [ 28 , 29 , 30 , 31 ]. Furthermore, elevated pro-inflammatory cytokines, such as TNF-α, IL-6 and IL-10 play a role in increasing metabolic demand [ 29 , 32 ]. Such pro-inflammatory cytokines were found to be elevated in critically ill neonates, implying that increased metabolic demand can also occur in the premature neonate population [ 32 , 33 ].…”

Section: Premature Infants Are In An Energy-deficit Statementioning

confidence: 99%

“…Furthermore, elevated pro-inflammatory cytokines, such as TNF-α, IL-6 and IL-10 play a role in increasing metabolic demand [ 29 , 32 ]. Such pro-inflammatory cytokines were found to be elevated in critically ill neonates, implying that increased metabolic demand can also occur in the premature neonate population [ 32 , 33 ]. An increase in metabolic demand will further decrease energy stores.…”

Section: Premature Infants Are In An Energy-deficit Statementioning

confidence: 99%

The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

2018

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Premature neonates are in an energy deficient state due to (1) oxygen desaturation and hypoxia events, (2) painful and stressful stimuli, (3) illness, and (4) neurodevelopmental energy requirements. Failure to correct energy deficiency in premature infants may lead to adverse effects such as neurodevelopmental delay and negative long-term metabolic and cardiovascular outcomes. The effects of energy dysregulation and the challenges that clinicians in the Neonatal Intensive Care Unit (NICU) face in meeting the premature infant’s metabolic demands are discussed. Specifically, the focus is on the effects of pain and stress on energy homeostasis. Energy deficiency is a complex problem and requires a multi-faceted solution to promote optimum development of premature infants.

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“…This is most likely an effect of time and disease stage, since our analysis was made in a situation of advanced end-stage liver disease just prior to LTx. One study that compared cytokine levels in biliary atresia children with advanced cirrhosis with those in healthy children found anti-inflammatory cytokines IL-10 and IL-6 to be elevated (17). Both cytokines correlated with disease stage and displayed a negative correlation with nutritional parameters.…”

Section: Discussionmentioning

confidence: 99%

Immune Status in Children Before Liver Transplantation—A Cross-Sectional Analysis Within the ChilsSFree Multicentre Cohort Study

et al. 2019

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Background: Both, markers of cellular immunity and serum cytokines have been proposed as potential biomarkers for graft rejection after liver transplantation. However, no good prognostic model is available for the prediction of acute cellular rejection. The impact of underlying disease and demographic factors on immune status before pediatric liver transplantation (pLTx) is still poorly understood. We investigated expression of immune markers before pLTx, in order to better understand the pre-transplant immune status. Improved knowledge of the impact of pre-transplant variables may enhance our understanding of immunological changes post pLTx in the future.Methods: This is a cross-sectional analysis of data from the ChilSFree study, a European multicentre cohort study investigating the longitudinal patterns of immune response before and after pLTx. Immune cell counts and soluble immune markers were measured in 155 children 1–30 days before pLTx by TruCount analysis and BioPlex assays. Results were logarithmised due to skewed distributions and then compared according to age, sex, and diagnosis using t-tests, ANOVAs, and Tukey post-hoc tests. The association between immune markers at time of pLTx and patients' age was assessed using a fractional polynomial approach. Multivariable regression models were used to assess the relative contribution of each factor.Results: Sex had no effect on immune status. We found strong evidence for age-specific differences in the immune status. The majority of immune markers decreased in a log-linear way with increasing age. T and B cells showed a sharp increase within the first months of life followed by a log-linear decline in older age groups. Several immune markers were strongly associated with underlying diagnoses. The effects of age and underlying disease remained virtually unchanged when adjusting for each other in multivariable models.Discussion: We show for the first time that age and diagnosis are major independent determinants of cellular and soluble immune marker levels in children with end-stage liver disease. These results need to be considered for future research on predictive immune monitoring after pLTx.

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IL-6, TNF-α, IL-10, and nutritional status in pediatric patients with biliary atresia

Cited by 13 publications

References 26 publications

Body Composition of Infants With Biliary Atresia

Body Composition of Infants With Biliary Atresia

The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

Immune Status in Children Before Liver Transplantation—A Cross-Sectional Analysis Within the ChilsSFree Multicentre Cohort Study

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