Impaired hepatic removal of interleukin-6 in patients with liver cirrhosis |
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| Authors: | Reiner Wiest Johanna Weigert Josef Wanninger Markus Neumeier Sabrina Bauer Sandra Schmidhofer Stefan Farkas Marcus N Scherer Andreas Schäffler Jürgen Schölmerich Christa Buechler |
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| Institution: | 1. Department of Internal Medicine I, Regensburg University Hospital, Regensburg, Germany;2. Department of Surgery, Regensburg University Hospital, Regensburg, Germany;1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China;2. Women and Children''s Hospital of Chengdu Medical College, Chengdu, China;3. Department of Clinical Laboratory, Sichuan Provincial Hospital for Women and Children, Chengdu, China;4. Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu, China;1. Radiology Department, Jinan Central Hospital Affiliated to Shandong University, China;2. Department of Nephrology, Jinan Central Hospital Affiliated to Shandong University, China;3. Outpatient Surgery, Jinan Central Hospital Affiliated to Shandong University, China;4. Department of Reproductive Medicine, Hospital for Maternity and Child Care of Jinan City, China;1. Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan;2. School of Medicine, Tzu Chi University, Hualien, Taiwan;3. Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan;4. Department of Nursing, Tzu Chi University, Hualien, Taiwan;5. Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan;6. Division of Nephrology, Tzu Chi General Hospital, Hualien, Taiwan;1. Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany;2. Institute of Medical Informatics, Charité – Universitätsmedizin Berlin, Berlin, Germany |
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| Abstract: | Systemic concentrations of interleukin-6 (IL-6) are elevated in patients with liver cirrhosis, and impaired hepatic uptake of IL-6 was suggested to contribute to higher levels in these patients. To test this hypothesis IL-6 was measured in portal venous serum (PVS), hepatic venous serum (HVS) and systemic venous serum (SVS) of 41 patients with liver cirrhosis and four patients with normal liver function. IL-6 was higher in PVS than HVS of all blood donors and about 43% of portal vein derived IL-6 was extracted by the healthy liver, and 6.3% by the cirrhotic liver demonstrating markedly impaired removal of IL-6 by the latter. Whereas in patients with CHILD-PUGH stage A IL-6 in HVS was almost 25% lower than in PVS, in patients with CHILD-PUGH stage C IL-6 was similarly abundant in the two blood compartments. Ascites is a common complication in cirrhotic patients and was associated with higher IL-6 levels in all blood compartments without significant differences in hepatic excretion. Hepatic venous pressure gradient did not correlate with the degree of hepatic IL-6 removal excluding hepatic shunting as the principal cause of impaired IL-6 uptake. Furthermore, patients with alcoholic liver cirrhosis had higher IL-6 in all blood compartments than patients with cryptogenic liver cirrhosis. Aetiology of liver cirrhosis did not affect hepatic removal rate indicating higher IL-6 synthesis in patients with alcoholic liver cirrhosis. In summary, the current data provide evidence that impaired hepatic removal of IL-6 is explained by hepatic shunting and liver dysfunction in patients with liver cirrhosis partly explaining higher systemic levels. |
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