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慢性肝病患者血浆中嗜酸性粒细胞趋化因子水平上调表明存在肝脏炎症、严重纤维化及不良临床病程。

Up-regulated eotaxin plasma levels in chronic liver disease patients indicate hepatic inflammation, advanced fibrosis and adverse clinical course.

作者信息

Tacke Frank, Trautwein Christian, Yagmur Eray, Hellerbrand Claus, Wiest Reiner, Brenner David A, Schnabl Bernd

机构信息

Medical Clinic III, University Hospital Aachen, Aachen, Germany.

出版信息

J Gastroenterol Hepatol. 2007 Aug;22(8):1256-64. doi: 10.1111/j.1440-1746.2006.04621.x.

Abstract

BACKGROUND AND AIMS

Recent studies highlight the role of chemokines for the attraction of inflammatory cells in liver injury and fibrogenesis. The CC chemokine ligand 11, eotaxin (CCL11), is up-regulated in senescent human hepatic stellate cells and crucial in animal models of T-cell mediated hepatitis. The aim of this study was to analyze the role of eotaxin in chronic liver disease.

METHODS

Plasma eotaxin levels of 111 patients with chronic liver disease were correlated with clinical presentation, laboratory parameters, liver histology and clinical course in a 6-year follow-up.

RESULTS

Eotaxin concentrations were significantly up-regulated in patients with liver cirrhosis and increased according to Child-Pugh and model of end-stage liver disease (MELD) score. Eotaxin correlated with the hepatic biosynthetic capacity and other inflammatory cytokines. High eotaxin was associated with hepatic necroinflammation and fibrosis in liver histology. In patients with typical clinical complications of cirrhosis, eotaxin was found to be increased. High eotaxin indicated an unfavorable prognosis in 6-year follow-up.

CONCLUSIONS

High eotaxin expression may be involved in the pathogenesis of chronic liver diseases. Plasma eotaxin levels correlate with the degree of liver cirrhosis and could serve as an additional biomarker indicating histological hepatic necroinflammation and fibrosis as well as an adverse clinical course.

摘要

背景与目的

近期研究强调趋化因子在肝损伤和纤维化形成过程中对炎性细胞的吸引作用。CC趋化因子配体11,即嗜酸性粒细胞趋化因子(CCL11),在衰老的人肝星状细胞中上调,且在T细胞介导的肝炎动物模型中起关键作用。本研究旨在分析嗜酸性粒细胞趋化因子在慢性肝病中的作用。

方法

对111例慢性肝病患者的血浆嗜酸性粒细胞趋化因子水平与临床表现、实验室参数、肝脏组织学及6年随访期内的临床病程进行相关性分析。

结果

肝硬化患者的嗜酸性粒细胞趋化因子浓度显著上调,并根据Child-Pugh评分和终末期肝病模型(MELD)评分升高。嗜酸性粒细胞趋化因子与肝脏生物合成能力及其他炎性细胞因子相关。高嗜酸性粒细胞趋化因子水平与肝脏组织学中的肝坏死性炎症和纤维化相关。在有典型肝硬化临床并发症的患者中,发现嗜酸性粒细胞趋化因子升高。高嗜酸性粒细胞趋化因子水平提示6年随访期预后不良。

结论

高嗜酸性粒细胞趋化因子表达可能参与慢性肝病的发病机制。血浆嗜酸性粒细胞趋化因子水平与肝硬化程度相关,可作为一种额外的生物标志物,提示肝脏组织学上的坏死性炎症和纤维化以及不良临床病程。

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