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Pro-inflammatory interleukin-18 and Caspase-1 serum levels in liver failure are unaffected by MARS treatment

G A Roth1, P Faybik, H Hetz

  • 1Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria. georg.roth@meduniwien.ac.at

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
|November 21, 2008
PubMed
Abstract

Insights

The Molecular Adsorbent Recirculating System (MARS) did not alter levels of IL-18 and Caspase-1 in patients with acute liver failure. This suggests MARS does not worsen outcomes by increasing these harmful cytokines.

Area of Science:

  • Hepatology
  • Critical Care Medicine
  • Biochemistry

Background:

  • Interleukin-18 (IL-18) and Caspase-1 are pro-inflammatory cytokines implicated in acute liver failure (ALF) and acute-on-chronic liver failure (ACLF).
  • The Molecular Adsorbent Recirculating System (MARS) is used to support liver function in ALF and ACLF.
  • Potential increases in IL-18 during extracorporeal support, similar to hemodialysis, could theoretically counteract MARS benefits.

Purpose of the Study:

  • To investigate the impact of MARS treatment on serum concentrations of IL-18 and Caspase-1 in patients with ALF and ACLF.
  • To determine if MARS therapy affects the levels of these potentially harmful cytokines.

Main Methods:

  • Serum IL-18 and Caspase-1 levels were measured in 10 ALF patients and 10 ACLF patients undergoing MARS treatment.
  • Control groups included 13 patients with chronic hepatic failure and 15 healthy individuals.
  • Data were analyzed using mean with 95% confidence intervals.

Main Results:

  • Baseline IL-18 and Caspase-1 serum concentrations were significantly elevated in ALF and ACLF patients compared to controls and chronic hepatic failure patients.
  • Serum concentrations of IL-18 and Caspase-1 did not show significant changes during MARS treatment in ALF and ACLF patients.
  • No significant alteration in IL-18 and Caspase-1 levels was observed during MARS therapy.

Conclusions:

  • MARS treatment had no significant effect on serum IL-18 and Caspase-1 concentrations in patients with ALF and ACLF.
  • The study found no evidence that MARS exacerbates liver injury by increasing IL-18 and Caspase-1 levels.
  • These findings suggest that MARS is not harmful regarding the modulation of these specific pro-inflammatory cytokines.

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