Value of inflammatory response and oxidative damage in the diagnosis of infections in severe alcoholic hepatitis

• Published in: European journal of internal medicine Vol. 119; pp. 64 - 70
• Main Authors: Pérez-Hernández, Onán, González-Reimers, Emilio, García-Rodríguez, Alen, Fernández-Rodríguez, Camino, Abreu-González, Pedro, González-Pérez, José María, Sánchez-Pérez, María José, Ferraz-Amaro, Iván, Martín-González, Candelaria
• Format: Journal Article
• Language: English
• Published: Netherlands 01.01.2024
• Subjects: Cytokines; Hepatitis, Alcoholic - complications; Hepatitis, Alcoholic - diagnosis; Humans; Interleukin-6; Oxidative Stress; Systemic Inflammatory Response Syndrome - diagnosis; Tumor Necrosis Factor-alpha; Oxidative stress; Cytokine release syndrome; Coinfection; Systemic inflammatory response syndrome; Alcoholic hepatitis; Sepsis; Alcohol-related liver disease
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2023.08.005

Severe alcoholic hepatitis is the most lethal complication in alcohol dependent patients. The concurrence of infections in these patients is very frequent. Both produce a systemic inflammatory response syndrome (SIRS), secondary to intense release of inflammatory cytokines, which can complicate the diagnosis. In our study, Interleukin (IL)-6 and IL-10 levels are higher in patients with SIRS (p<0.001 and p = 0.033, respectively). IL-4, IL-6, Interferon-gamma (IFNγ), Tumor necrosis factor alpha (TNFα) and IL-17 levels correlate with liver function, as estimated by MELD-Na (p = 0.018, p = 0.008, p = 0.009, p = 0.016 and p = 0.006, respectively). Malondialdehyde (MDA), a product of lipid peroxidation and marker of cell damage, also correlates with liver function (p = 0.002), but not with SIRS or infections. Only elevated IL-6 correlates independently with the presence of infections (RR=1.023 IC 95% 1.000-1.047), so it may be useful for the correct diagnosis in these patients. Values greater than 30 pg/mL have a sensitivity: 86.7% and specificity: 94.7% for the diagnosis of infections.