Hyperdynamic circulation and elevated portal pressure are established features of cirrhosis. In patients with alcoholic cirrhosis with superadded inflammation an inflammatory cytokine cascade perpetuates further injury.
In this study, researcher from London, England, hypothesized that this additional hepatic inflammation is central to deterioration in patients’ portal hemodynamics.
The team compared 10 patients with cirrhosis and superadded inflammation on biopsy (alcoholic hepatitis (AH)), with 13 patients with alcoholic cirrhosis (AC) only.
They assessed cardiovascular hemodynamics and wedged hepatic venous pressure gradient (HVPG) in both groups. Clinical and biomedical profiles were also assessed.
In addition, IL-6 and IL-8 plasma levels were assayed.
|Patients with alcoholic hepatitis had elevated white blood cell counts compared to patients with alcoholic cirrhosis.|
The team found that patients with AH had elevated white blood cell counts, C-reactive protein, and systemic inflammatory response syndrome scores, when compared with patients with AC.
Furthermore, the team identified significant differences in hemodynamics between the 2 groups following nonparametric analysis.
The pro-inflammatory cytokines, IL-6 and IL-8, also showed substantial increases in the AH group, compared to the AC group.
Dr Mookerjee’s team concluded, “This study demonstrates a significant difference in portal and systemic hemodynamics between patients with alcoholic cirrhosis and those with additional hepatic inflammation”.
This highlights, “The contribution of inflammation to the development of portal hypertension in these patients”.