Changes in Ascitic Fluid Polymorphonuclear Cell Count After Antibiotics Are Associated With Mortality in Spontaneous Bacterial Peritonitis

Saffo, Saad; To, Uyen; Santoiemma, Phillip P.; Laurito, Marcela; Haque, Lamia; Rabiee, Anahita; Verna, Elizabeth C.; Angarone, Michael; García–Tsao, Guadalupe

doi:10.1016/j.cgh.2021.07.019

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…Even in non-infected ascites, a higher PMN count is associated with a worse prognosis [40]. Furthermore, those who do not have an adequate reduction in their PMN count after antibiotic treatment for SBP have a worse prognosis than those that do [41]. Compared to neutrophils from non-infected ascites, in SBP ascitic neutrophils express lower levels of the activation markers CD69 and CD80, have impaired NET generation [30] and have impaired oxidative burst activity [25].…”

Section: Neutrophilsmentioning

confidence: 99%

Peritoneal Immunity in Liver Disease

Delo

Forton

Triantafyllou

et al. 2023

Livers

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The peritoneum represents a confined microenvironment that has an emerging role as a distinct immunological compartment. In health, this niche is mainly populated by a heterogenous group of macrophages and T lymphocytes but also Natural Killer cells and B lymphocytes. Together they are crucial for immunological surveillance, clearance of infection and resolution of inflammation. Development of ascites is a defining feature of decompensated liver cirrhosis, and spontaneous bacterial peritonitis is the most frequent bacterial infection occurring in this patient group. Recent studies of ascitic fluid have revealed quantitative, phenotypic and functional differences in both innate and adaptive immune cells compared to the healthy state. This review summarises current knowledge of these alterations and explores how the peritoneum in chronic liver disease is simultaneously an immunologically compromised site and yet capable of provoking an intense inflammatory response. A better understanding of this might enable identification of new therapeutic targets aimed to rebalance the peritoneal immunity and reduce the reliance on antimicrobials in an era of increasing antimicrobial resistance.

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Section: Neutrophilsmentioning

confidence: 99%

Peritoneal Immunity in Liver Disease

Delo

Forton

Triantafyllou

et al. 2023

Livers

View full text Add to dashboard Cite

show abstract

“…We read with great interest the article by Saffo et al 1 where authors have shown that the reduction in polymorphonuclear (PMN) cell count of ascitic fluid in patients with spontaneous bacterial peritonitis (SBP) is a predictor of mortality. The findings are important because this is the first study to demonstrate the importance of absolute reduction in PMN counts as a predictor of survival.…”

Section: Assessment Of Change In Polymorphsmentioning

confidence: 99%