Proinflammatory and Anti-Inflammatory Cytokine Balance in Patients With Cirrhotic Hepatitis During Live-Donor Liver Transplant

Abstract

Objectives: The immune system releases cytokines during the stress response, and the balance between proinflammatory and anti-inflammatory cytokines is important. This prospective study was done to determine which cytokines are responsible for maintaining cytokine balance during live-donor liver transplant surgery. Materials and Methods: Recipients undergoing livedonor liver transplant surgery due to cirrhotic hepatitis were allocated to a recipient group (n=44), and healthy donors were placed in the donor group (n=45). In donors, blood sampling for cytokine level analysis was performed after anesthetic induction (before the start of surgery, time point 1). In recipients, blood samples were collected before the start of surgery (time point 1), 60 minutes after the start of the anhepatic period (time point 2), and 60 minutes after reperfusion (time point 3). The proinflammatory cytokines measured were interleukin-1β, interleukin-6, and tumor necrosis factor-α; the anti-inflammatory cytokines were interleukin-10 and interleukin-4. Cytokines were quantified using sandwich enzyme-linked immunoassays. The time course of proinflammatory and anti-inflammatory cytokine concentrations during surgery in the recipient group was evaluated.Results: Interleukin-6, interleukin-10 and tumor necrosis factor-α showed significant changes in concentration during surgery, with interleukin-6 reaching levels 40 times higher than the preoperative value at the anhepatic stage. Interleukin-10 reached a peak at the neohepatic phase, with values 60 times higher than the preoperative value. The preoperative concentrations of interleukin-6 and interleukin-10 in the recipient group were higher than those in the donor group with a median of 4.48 vs 1.98 pg/mL (P < .001) and 2.98 vs 1.22 (P = .026). Conclusions: Interleukin-6 and interleukin-10 play a major role in cytokine balance before and during live-donor liver transplant surgery.

Considering the Effect of <i>Rosa damascena</i> Mill. Essential Oil on Oxidative Stress and <i>COX-2</i> Gene Expression in the Liver of Septic Rats

“…6 The imbalance between pro-inflammatory and antiinflammatory parameters is responsible for the susceptibility to and outcome of sepsis. 7 By increasing oxidative stress and reactive oxygen species (ROS), the body's antioxidant system is impaired, leading to effects on the cells and mitochondria and finally causing organ dysfunction. 8 To investigate the pathogenesis of sepsis and its mechanisms, three methods are usually utilized: 1) injection and using lipopolysaccharides (LPS) and other exogenous toxin like zymogens; 2) applying different fatal and vivid pathogens; 3) elimination or changing the endogenous protective barrier, like cecal ligation and puncture (CLP) and colon ascendens stent peritonitis.…”

Pathophysiologic Implications of Cytokines Secretion during Liver Transplantation Surgery

“…Koh et al 9 performed a study regarding this issue and demonstrated this condition. Their results showed that the cytokines released markedly in patients with cirrhotic hepatitis during liver transplant surgery include IL-6 (a pro-inflammatory cytokine whose concentration increased as much as 40 times compared to its preoperative values at the anhepatic stage) and IL-10 (an anti-inflammatory cytokine whose concentration was 60 times higher than its preoperative value at the neohepatic phase) (Table 1).…”

“…Previous studies on cytokines secretion related to liver transplantation in patients with liver failure mostly focused on the types and subtypes of cytokines secreted during each stage of surgery 3, the serial changes in their concentrations during the surgery 4, and their relation to postoperative outcome after transplantation 5, 6. Additionally, several studies to elucidate the following issues have been done; factors influencing the secretion of cytokines during liver transplantation 7, 8, pro-inflammatory and anti-inflammatory cytokine balance during liver transplantation surgery 9, and the changes in the ratio of T helper 1 (Th 1) to T helper 2 (Th 2), and T helper 17 (Th 17) to regulatory T (Treg) cell signature cytokines during liver transplantation surgery with tools to change on the levels of Th 1, Th 2, Th17 and Treg cell signature cytokines 10. In this review article, we aim to introduce these studies regarding cytokines secretion during liver transplantation and to suggest study directions for better outcomes of the patients.…”