Characterization of inflammatory response in hepatorenal syndrome : Relationship with kidney outcome and survival
Solé, Cristina (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Solà, Elsa (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Huelin, Patricia (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Carol, Marta (Universitat de Barcelona)
Moreira, Rebeca (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Cereijo, Unai (Anaxomics Biotech)
Mas, José-Manuel (Anaxomics Biotech)
Graupera, Isabel (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Pose, Elisa (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Napoleone, Laura (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
dePrada, Gloria (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Juanola, Adrià (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Fabrellas, Núria (Universitat de Barcelona)
Torres, Ferran (Universitat Autònoma de Barcelona. Departament de Medicina)
Morales-Ruiz, Manuel (Hospital Clínic i Provincial de Barcelona)
Farrés, Judith (Anaxomics Biotech)
Jiménez, Wladimiro (Hospital Clínic i Provincial de Barcelona)
Ginès, Pere (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	Several lines of evidence indicate that decompensated cirrhosis is characterized by the presence of systemic inflammation. Hepatorenal syndrome (HRS-AKI) is a unique type of renal failure that occurs at late stages of cirrhosis. However, confirmation of the presence and significance of such inflammatory response in HRS-AKI is lacking. To characterize the systemic inflammatory response, as estimated by measuring a large number of cytokines, in 161 patients hospitalized for an acute decompensation of cirrhosis: 44 patients without acute kidney injury (AKI), 63 patients with hypovolaemia-induced AKI and 58 patients with HRS-AKI. HRS-AKI was characterized by an altered cytokine profile compared to the other two groups, particularly IL-6, IL-8, TNF-α, VCAM-1, fractalkine and MIP-1α. The inflammatory response was not related to presence of bacterial infection, concomitant acute-on-chronic liver failure or severity of renal dysfunction. Patients who responded to terlipressin and albumin had only a decrease in TNF-α and RANTES after treatment without changes in other cytokines. Interestingly, patients with persistent HRS-AKI had higher levels of IP-10 and VCAM-1 compared to those with resolution of HRS-AKI. VCAM-1 was also an independent predictor of 3-month mortality. A systems biology analysis approach showed that the inflammatory status of HRS-AKI was similar to that of chronic nonhepatic inflammatory conditions, such as lupus erythematosus or inflammatory bowel disease. Hepatorenal syndrome is characterized by a marked systemic inflammatory state, reminiscent of that of nonhepatic inflammatory diseases, that correlates with patient outcomes. See Editorial on Page.
Ajuts:	Instituto de Salud Carlos III PI-12-00330
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	AKI ; Cirrhosis ; Hepatorenal syndrome ; Inflammation
Publicat a:	Liver International, Vol. 39 (february 2019) , p. 1246-1255, ISSN 1478-3231

DOI: 10.1111/liv.14037
PMID: 30597709

10 p, 517.0 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats