Background&Aim: Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhotics with ascites . The immune system plays an important role in the development or eradication of this infection, however there is a lack of knowledge about this issue in ascitic infections. The aim of this study was to investigate lymphocyte subgroups and some cytokine levels in ascitic fluid (AF) in cirrhotic patients with and without SBP.
Methods: A case-control study consisted of 31 cirrhotic patients with ascites, divided into two groups (16 SBP, 15 non-SBP). For all patients, AF samples were examined for leucocytic count and differentiation ,lymphocyte surface markers (CD3,CD4,CD8) by flow cytometry, albumin, protein, glucose, serum-ascitic albumin gradient, bacterial growth on BACTEC blood culture bottles together with both serum and AF levels of tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6).
Results: Lower CD4, CD4/CD8 ratio and higher CD8 were detected in patients with SBP. Serum IL-6 levels and (TNF-α) were significantly higher in patients with SBP, but in AF, IL-6 levels only were significantly higher in patients with SBP. Also, AF IL-6 increased significantly in culture negative patients with SBP (p=0.04).
Conclusion: Measurements of ascitic fluid IL-6 in cirrhotics with ascites could be a useful guide for detection of SBP especially in patients with negative cultures. Changes in the T lymphocyte subpopulation may be involved in the pathogenic process of ascites infection. |
