Evaluation of some Cytokine Responses in Ascitic Fluid; Their Relation to Circulating Immune Complexes

There is no clear consensus about the pattern of cytokine production and regulation that causes patients with chronic schistosomiasis to develop severe hepatosplenic disease, which is characterized by peri-portal fibrosis and portal hypertension. Circulating immune complexes [CICs], play an important role in the pathogenesis of many clinical syndromes during the course of hepatic schistosomiasis. Therefore, the aim of this study was to estimate interleukin-6 [IL-6] and tumor necrosis factor-α] levels in serum and ascetic fluid [AF] of schistosomal patients and to evaluate these cytokines response in relation to circulating immune complexes. Material and methods: The study enrolled 40 patients with hepatic schistosomiasis forming two groups; 20 patients with ascites [group I] and the other 20 patients without ascites [group II]. Apart from complete history taking, clinical examination, and routine laboratory work, blood and ascetic fluid [AF] samples were collected from the patients after hospital admission. Estimation of IL-6 and TNF-α in serum and AF according to the manufacturer instructions. Moreover, serum circulating immune complexes [CICs] were assayed as well. Results: The mean serum level of IL-6 was 156.9±150.82 pg/ml in schistosomal ascetic patients and 121.63±68.47 pg/ml in non-ascetic cases. The mean serum concentration of TNF-α was 88.5±70.59 pg/ml in group I and 66±46.76 pg/ml in group II patients. IL-6 concentration in the ascetic fluid of schistosomal patients had a mean of 284.4±280.08 pg/ml while ascetic fluid TNF-α had a mean of 113.25±58.97 pg/ml. Schistosomal patients with ascites were shown to have significantly higher levels of IL-6 and TNF-α in their ascetic fluid than in serum. A significant positive correlation was detected between the serum and AF concentrations of IL-6 [r-=0.559], and TNF-α [r-=0.556*], P