Cytokine Dependent Hematopoietic Cell Linker and Anemia in Liver Cirrhosis Patients

Abstract

Background: About 75% of people with liver cirrhosis have anemia. It significantly lowers their quality of life and raises mortality. Additionally, several etiologies may be involved. A tyrosine-phosphorylated polypeptide called cytokine dependent hematopoietic cell linker (CLNK) controls immunological receptor signalling and controls the receptor signalling of T-cells and natural killer T-cells. Tyrosine of the cytoplasmic domain band-3 is phosphorylated by oxidative stress, which is a significant factor in the development of liver cirrhosis. Tyrosine phosphorylation thus triggers the release of microparticles, local red cell membrane instability, and major changes in erythrocyte shape. It has not been previously investigated how CLNK affects liver cirrhosis and anemia caused by cirrhosis. Objectives: The aim of the current study was to evaluate serum level of CLNK in cirrhotic patients compared to healthy controls, and its level was correlated with various hematological parameters. Patients and methods: A case-control study was conducted on 60 liver cirrhotic patients (30 anemic and 30 not anemic) and 30 age and sex-matched healthy individuals. All patients were subjected to full history taking, complete medical examination, and thorough radiological and laboratory investigations as complete blood counts, ferritin, CRP, liver function tests, kidney function tests, and serum CLNK using enzyme-linked immunosorbent assay were done. Results: Serum CLNK levels were significantly higher in anemic [178.86 (IQR 68.25)]) and nonanemic cirrhotic patients [138.17 (IQR 170.55)] than in controls [90.28 (IQR 10.61) with a P-value <0.001. There was no significant difference between anemic and non-anemic groups compared with each other. CLNK serum levels showed a statistically significant positive correlation with ferritin and reticulocyte count in anemic patients' groups. Conclusion: Serum CLNK is significantly elevated in patients with liver cirrhosis and there is still some debate regarding the association between CLNK levels and the incidence of anemia in cirrhotic patients.