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Soluble TNF-R1, but not tumor necrosis factor alpha, predicts the 3-month mortality in patients with alcoholic hepatitis
- Source :
- Journal of Hepatology. 41:229-234
- Publication Year :
- 2004
- Publisher :
- Elsevier BV, 2004.
-
Abstract
- Background/Aims In alcoholic hepatitis (AH), soluble TNFα receptor-1 (sTNF-R1) is increased. Elevated TNFα predicts mortality, but infection influences TNFα values. In patients with AH, we determined the prognostic value of TNFα, sTNF-R1, and lipopolysaccharide binding protein (LBP) and CD14, both involved in endotoxemia-associated inflammation. Methods One hundred and eight cirrhotic patients (Pugh score 10 [6–13]) and biopsy-proven AH (Maddrey's DF n =46; ≥32: n =62) without associated infection were included within 8 days of admission and followed-up for 3 months. Cytokines were measured using specific immunoassays. Patients with severe AH received steroids. Results Twenty four patients died at a median time of 35 days (range: 3–89). The overall survival was 78%. Multivariate Cox regression analysis showed that sTNF-R1 was an independent predictor of mortality, (OR 4.33: 95% CI [1.12–16.75]). Pugh's score ( P =0.618), Maddrey's DF ( P =0.182), creatinine ( P =0.197), TNFα ( P =0.319), LBP ( P =0.362), and CD14 ( P =0.347) were not related to survival. Conclusions In patients with AH, sTNF-R1 measured at admission is an independent predictor of survival at 3 months. Provided that TNF-R1 mediates the cytotoxic actions of TNFα, these results support the concept of dysregulated TNFα metabolism in AH.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Alcohol Drinking
CD14
Alcoholic hepatitis
Gastroenterology
chemistry.chemical_compound
Internal medicine
medicine
Humans
Survival analysis
Aged
Hepatitis
Creatinine
Hepatology
biology
Hepatitis, Alcoholic
Tumor Necrosis Factor-alpha
Proportional hazards model
business.industry
Middle Aged
Prognosis
medicine.disease
Survival Analysis
ROC Curve
Solubility
chemistry
Receptors, Tumor Necrosis Factor, Type I
Immunology
biology.protein
Regression Analysis
Female
Tumor necrosis factor alpha
business
Lipopolysaccharide binding protein
Subjects
Details
- ISSN :
- 01688278
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Journal of Hepatology
- Accession number :
- edsair.doi.dedup.....b86a717bbf38cda2c57505edb14c703d