Ex Vivo T Cell Cytokine Expression Predicts Survival in Patients with Severe Alcoholic Hepatitis.

Ex Vivo T Cell Cytokine Expression Predicts Survival in Patients with Severe Alcoholic Hepatitis. Gut Liver. 2019 Jun 03;: Authors: Dhanda AD, Yates E, Schewitz-Bowers LP, Lait PJ, Lee RWJ, Cramp ME Abstract Alcoholic hepatitis (AH) is an acute inflammatory liver condition with high early mortality rate. Steroids have been demonstrated to lead to short-term survival benefits but nonresponders have the worst outcomes. There is a clinical need to identify these high-risk individuals at the time of presentation. T cells have been implicated in AH and steroid responsiveness. We aimed to measure ex vivo T cell cytokine expression as a candidate biomarker of outcomes in patients with AH. Consecutive patients with AH (patients with bilirubin levels >80 µmol/L and the ratio of aspartate aminotransferase to alanine aminotransferase >1.5 who were heavy alcohol consumers with discriminant function [DF] ≥32), were recruited from University Hospitals Plymouth NHS Trust. T cells were obtained and stimulated ex vivo before cytokine expression levels were determined by flow cytometry and protein multiplex analysis. Twenty-three patients were recruited (10 male; median age 51 years; baseline DF 67; 30% 90-day mortality). Compared to T cells from nonsurvivors at day 90, T cells from survivors had higher baseline intracellular IL-10:IL-17A ratios (0.43 vs 1.20, p=0.02). Multiplex protein analysis identified interferon γ (IFNγ) and tumor necr...
Source: Gut and Liver - Category: Gastroenterology Tags: Gut Liver Source Type: research