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Serum interleukin 8 and 12 levels predict severity and mortality in patients with alcoholic hepatitis
Onkar P Patel1, Mohd Talha Noor, Ravindra Kumar
1Department of Gastroenterology, Sri Aurobindo Medical College and Post Graduate Institute, Indore, 453 555, India.
Background:
Alcoholic hepatitis (AH) is a common life-threatening illness particularly when it is severe. Alcoholic liver disease is associated with cytokine imbalance. There is paucity of information about the relationship of interleukin (IL) levels with severity and mortality of patients with AH. Our aim was to correlate serum IL-8 and IL-12 values with disease severity (mild vs. severe) and mortality.
Methods:
Fifty patients and 25 healthy subjects were included in the study. Serum IL-8 and -12 levels were analyzed and correlated with disease severity and mortality. Predictive value for 6 months mortality of IL-8, IL-12, Maddreys discriminant function (mDF), age, bilirubin, international normalized ratio, and creatinine score (ABIC) and Glasgow alcoholic hepatitis score (GAHS) was compared by the area under the receiver operating curve (AUROC).
Results:
Mean (±SD) serum IL-8 levels were significantly higher in patients with severe AH as compared to mild AH [539.04 ± 89.77 vs. 253.66 ± 56.66 pg/mL (p < 0.001)] and controls [539.04 ± 89.77 vs. 99.96 ± 20.94 pg/mL (p < 0.001)]. Similarly, mean (+SD) serum IL-12 levels in severe AH were also significantly higher as compared to mild AH [344.47 ± 93.04 vs. 101.92 ± 16.70 pg/mL (p < 0.001)] and controls [344.47 ± 93.04 vs. 47.84 ± 11.22 pg/mL (p < 0.001)]. AUROCs of IL-8, IL-12, mDF, ABIC, and GAHS were 0.995, 0.998, 0.975, 0.873, and 0.883 for predicting 6 months mortality.
Conclusion:
Serum IL-8 and -12 levels were markedly elevated in AH with increasing levels as the severity increases. Serum levels of IL-8 and -12 were better predictors of short-term mortality as compared to conventional prognostic scores.
