Details

Autor(en) / Beteiligte

• Matiollo, Camila
• Rateke, Elayne Cristina de Moraes
• de Oliveira, Karina Ghisoni
• Turnes, Bruna Lenfers
• da Silva, Telma Erotides
• Maccali, Claudia
• Latini, Alexandra Susana
• Narciso-Schiavon, Janaína Luz
• Schiavon, LL

Titel

Elevated neopterin levels are associated with acute-on-chronic liver failure and mortality in patients with liver cirrhosis

Ist Teil von

• Digestive and liver disease, 2020-07, Vol.52 (7), p.753-760

Ort / Verlag

Netherlands: Elsevier Ltd

Erscheinungsjahr

2020

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Macrophage activation plays a central role in hepatic and systemic inflammation and is involved in the pathogenesis of acute-on-chronic liver failure (ACLF). This study aimed to investigate neopterin levels in patients admitted for acute decompensation (AD) of cirrhosis, evaluating its relationship with ACLF and prognosis. This prospective cohort study included 205 adult subjects hospitalized for AD of cirrhosis. Twenty-one healthy subjects and 89 patients with stable cirrhosis were evaluated as controls. Circulating neopterin was higher in AD as compared to stable cirrhosis and healthy controls (p<0.001). ACLF was independently associated with higher neopterin levels (OR 1.015, 95% CI 1.002–1.028, p = 0.025). In the multivariate Cox regression analysis, neopterin levels (HR = 1.002, IC 95% 1.000–1.004, p = 0.041), Child–Pugh class C, and ACLF were predictors of 30-day survival. Among patients with ACLF, the Kaplan–Meier survival probability was 71.4% in those with neopterin levels < 25 nmol/L and 31.0% if neopterin ≥ 25 nmol/L (p<0.001). Higher circulating neopterin was associated with ACLF in patients hospitalized for AD of cirrhosis. Neopterin levels were also independently predictors of high short-term mortality, especially among patients with ACLF, and could represent a useful biomarker of macrophage activation in clinical practice.