Kaps Leonard, Schleicher Eva Maria, Medina Montano Carolina, Bros Matthias, Gairing Simon Johannes, Ahlbrand Constantin Johannes, Michel Maurice, Klimpke Pascal, Kremer Wolfgang Maximilian, Holtz Stefan, Boedecker-Lips Simone Cosima, Galle Peter Robert, Kraus Daniel, Schattenberg Jörn M, Labenz Christian, Weinmann-Menke Julia
Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University, 55131 Mainz, Germany.
Cirrhosis Centre Mainz (CCM), University Medical Centre of the Johannes Gutenberg-University, 55131 Mainz, Germany.
J Clin Med. 2022 May 15;11(10):2782. doi: 10.3390/jcm11102782.
Background: ADVanced Organ Support (ADVOS) is a novel type of extracorporeal albumin dialysis that supports multiorgan function in patients with acute-on-chronic liver failure (ACLF). No data exist on whether ADVOS affects inflammatory cytokine levels, which play a relevant role in ACLF. Aim: Our aim was to quantify cytokine levels both before and after a single ADVOS treatment in patients with ACLF at a regular dialysis ward. Methods and results: In this prospective study, 15 patients (60% men) with ACLF and an indication for renal replacement therapy were included. Patient liver function was severely compromised, reflected by a median CLIF-consortium ACLF score of 38 (IQR 35; 40). Blood samples were directly taken before and after ADVOS dialysis. The concentration of cytokines for IL-1β, IFN-α2, IFN-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, IL-33 were quantified via a cytometric bead array. We found no significant (p > 0.05) change in cytokine levels, even when patients were stratified for dialysis time (<480 min versus ≥480 min). The relevance of the assessed cytokines in contributing to systemic inflammation in ACLF was demonstrated by Ingenuity pathway analysis®. Conclusion: Concentrations of pathomechanistically relevant cytokines remained unchanged both before and after ADVOS treatment in patients with ACLF.
先进器官支持（ADVOS）是一种新型的体外白蛋白透析技术，可支持慢性肝衰竭急性发作（ACLF）患者的多器官功能。目前尚无关于ADVOS是否会影响炎症细胞因子水平的数据，而炎症细胞因子在ACLF中发挥着重要作用。目的：我们的目的是对常规透析病房中接受单次ADVOS治疗的ACLF患者治疗前后的细胞因子水平进行定量分析。方法与结果：在这项前瞻性研究中，纳入了15例有肾替代治疗指征的ACLF患者（60%为男性）。患者的肝功能严重受损，CLIF联盟ACLF评分中位数为38（四分位间距35；40）。在ADVOS透析前后直接采集血样。通过细胞计数珠阵列对白细胞介素-1β、干扰素-α2、干扰素-γ、肿瘤坏死因子-α、单核细胞趋化蛋白-1、白细胞介素-6、白细胞介素-8、白细胞介素-10、白细胞介素-12p70、白细胞介素-17A、白细胞介素-18、白细胞介素-23、白细胞介素-33等细胞因子的浓度进行定量分析。我们发现细胞因子水平没有显著变化（p>0.05），即使根据透析时间（<480分钟与≥480分钟）对患者进行分层分析也是如此。通过Ingenuity pathway analysis®证明了所评估的细胞因子在ACLF全身炎症中的相关性。结论：ACLF患者在接受ADVOS治疗前后，与发病机制相关的细胞因子浓度均保持不变。
