Interleukin-6, Nitric Oxide, and the Clinical and Hemodynamic Alterations of Patients With Liver Cirrhosis

Genescà, Joan; González, Antonio; Segura, Rosa; Catalan, Robert; Martí, Ramón; Varela, Encarna; Cadelina, Gregory; Martinez, M.; López-Talavera, Juan Carlos; Esteban, Rafael; Groszmann, Roberto J.; Guàrdia, J

doi:10.1111/j.1572-0241.1999.00790.x

Cited by 108 publications

(30 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Plasma concentrations of inflammatory cytokines are increased in these patients, even in the absence of active infection (19,50,55), and this activation of inflammatory mediators might explain the decrease in HRV observed in these patients.…”

mentioning

confidence: 99%

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Mani¹,

Montagnese²,

Jackson³

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

111

View full text Add to dashboard Cite

Mani AR, Montagnese S, Jackson CD, Jenkins CW, Head IM, Stephens RC, Moore KP, Morgan MY. Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy. Am J Physiol Gastrointest Liver Physiol 296: G330 -G338, 2009. First published November 20, 2008 doi:10.1152/ajpgi.90488.2008.-Heart rate variability (HRV) is reduced in several clinical settings associated with either systemic inflammation or neuropsychiatric impairment. The possibility that the changes in HRV observed in patients with neuropsychiatric impairment might relate to the overproduction of inflammatory cytokines does not seem to have been considered in the studies undertaken to date. HRV is decreased in patients with liver cirrhosis but its relationship to the impairment of neuropsychiatric performance, commonly observed in these patients, is unknown. The aim of this study was to investigate the relationship between HRV, hepatic encephalopathy, and production of inflammatory cytokines in patients with cirrhosis. Eighty patients with cirrhosis [53 men, 27 women; mean (Ϯ1SD) age 54 Ϯ 10 yr], classified as neuropsychiatrically unimpaired or as having minimal or overt hepatic encephalopathy, and 11 healthy subjects were studied. HRV was assessed by applying Poincaré plot analysis to the R-R interval series on a 5-min ECG. Inflammatory cytokines (TNF-␣, IL-6, IL-10, and IL-12) were measured in a subgroup of patients. Long-term R-R variability was significantly decreased in the patients with cirrhosis, in parallel with the degree of neuropsychiatric impairment (P Ͻ 0.01) and independently of the degree of hepatic dysfunction (P ϭ 0.011). The relative risk of death increased by 7.7% for every 1-ms drop in this variable. Plasma levels of IL-6 significantly correlated with indexes of both HRV and neuropsychiatric performance. The changes observed in HRV and in neuropsychiatric status in patients with cirrhosis are significantly correlated, most likely reflecting a common pathogenic mechanism mediated by inflammatory cytokines.

show abstract

mentioning

confidence: 99%

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Mani¹,

Montagnese²,

Jackson³

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

111

View full text Add to dashboard Cite

show abstract

“…For example, NO is a potent inducer of increased membrane permeability in the vascular endothelium and intestinal mucosa, possibly contributing to the accumulation of ascites and to bacterial translocation [31] . In the current study, although TNF-α was thought to induce NO synthesis (NOS) through the inducible NOS and endothelial NOS [32,33] , there was no significant correlation between TNF-α level and NO level in LC. This is the same to some studies, where such a relation could not be observed [34,35] .…”

Section: Cirrhotics Without Ascites (N = 27)mentioning

confidence: 83%

Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

Lee¹,

Son²,

Han³

et al. 2008

WJG

View full text Add to dashboard Cite

AIM:To determine intestinal permeability, the serum tumor necrosis factor (TNF)-α level and urine nitric oxide (NO) metabolites are altered in liver cirrhosis (LC) with or without ascites. METHODS: Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol (PEG) 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay (ELISA) and Greiss reaction method, respectively. RESULTS: The intestinal permeability index was significantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites (0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03, P < 0.05) and correlated with urine nitrite excretion (r = 0.98). Interestingly, the serum TNF-α concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites (198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL, P < 0.05). Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites (1170.9 ± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L, P < 0.05). CONCLUSION:Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-α concentration was not related to LC with ascites.

show abstract

“…Animal studies suggesting that inflammationassociated alterations may contribute to cognitive impairment in hepatic encephalopathy [32]. Higher levels of TNFα and IL-6 are detectable in the serum of patients with fulminant hepatitis and cirrhosis [33,34] and inflammatory cytokines in patients with infections and liver disease could influence brain function at different levels including the cerebral endothelial cell and Astrocytes [35]. Our finding revealed a relation between Ozone concentration and hepatic encephalopathy severity which further support the potential role of inflammatory cytokines on brain function among cirrhotics although our study has some limitation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Relation Between Air Pollution and Hepatic Encephalopathy Exacerbation

Alavinejad¹,

Mard²,

Esk³

et al. 2016

GHOA

View full text Add to dashboard Cite

In this retrospective cross sectional survey, by evaluating the records of Ahvaz aerology stations and air pollution committee of Ahvaz Jundishapur University, the DATA about 4 major air AbstractBackground: To evaluate relation between air pollution and rate and duration of hospital admission due to hepatic encephalopathy as a major complication of liver cirrhosis. Methods:In this retrospective study, during a 10 months period, the number and average duration of hospitalization of patients admitted in GI ward of a referral center due to hepatic encephalopathy were recorded in an industrial capital city. Concomitantly the level of 4 major air pollutants including SO 2 , CO, NO 2 and O 3 measured and the correlation between severity of hepatic encephalopathy and air pollution determined by Pearson correlation coefficient.Results: Average number of admission was 5 to 6 patients per month (1-10). The average duration of hospitalization was 7.6 days (3-19). After comparison of average concentration of 4 major air pollutants with rate of hepatic encephalopathy, there was a relation, between O3 concentration and duration of admissions (P=0.048, correlation coefficient 0.636) and also a non-significant relation between O3 concentration and number of admissions (P=0.78, correlation coefficient 0.58). DATA analysis did not reveal any significant relation between SO 2 , NO 2 and CO and the rate and duration of admission due to hepatic encephalopathy (P > 0.05). Conclusion:It seems that O 3 as one of the major air pollutants can aggravates course of hepatic encephalopathy. This issue should further be clarified in future studies.

show abstract

Interleukin-6, Nitric Oxide, and the Clinical and Hemodynamic Alterations of Patients With Liver Cirrhosis

Cited by 108 publications

References 40 publications

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Decreased heart rate variability in patients with cirrhosis relates to the presence and degree of hepatic encephalopathy

Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

Evaluation of Relation Between Air Pollution and Hepatic Encephalopathy Exacerbation

Contact Info

Product

Resources

About