In alcoholic hepatitis, soluble TNF-alpha receptor-1 (sTNF-R1) is increased.
In this study, doctors from Switzerland assessed the prognostic values of TNF-alpha, sTNF-R1, and lipopolysaccharide binding protein (LBP) and CD14, in these patients.
They examined 108 cirrhotic patients with biopsy-proven alcoholic hepatitis without associated infection. Patients were included within 8 days of admission and followed-up for 3 months.
The team measured cytokines using specific immunoassays.
|Soluble TNF-alpha receptor-1 is an independent predictor of mortality.|
|Journal of Hepatology|
In addition, patients with severe alcoholic hepatitis received steroids.
The doctors found that 24 patients died at a median 35 days. They found that the overall survival was 78%.
Using multivariate Cox regression analysis, the team determined that sTNF-R1 was an independent predictor of mortality (OR 4.33).
They also established that Pugh's score, Maddrey's DF, creatinine, TNF-alpha, LBP, and CD14 not related to survival.
Dr Laurent Spahr and colleagues concluded, "In patients with alcoholic hepatitis, sTNF-R1 measured at admission is an independent predictor of survival at 3 months".
"Provided that TNF-R1 mediates the cytotoxic actions of TNF-alpha, these results support the concept of dysregulated TNF-alpha metabolism in alcoholic hepatitis".