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Erschienen in: Digestive Diseases and Sciences 12/2007

01.12.2007 | Original Paper

Clinical Features, Serum Interleukin-6, and Interferon-γ Levels of 34 Turkish Patients With Hepatoportal Sclerosis

verfasst von: Aydın Şeref Köksal, Seyfettin Köklü, Mehmet İbiş, Mustafa Balcı, Bahattin Çiçek, Nurgül Şaşmaz, Burhan Şahin

Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2007

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Abstract

Hepatoportal sclerosis (HPS) is a clinical disorder of obscure pathogenesis with a variable clinical profile. The aim of the study was to summarize the clinical features of Turkish patients with HPS and to measure the serum levels of interleukin (IL)-6 and interferon (IFN)-γ to determine the T helper cell profile in the pathogenesis. The study was conducted on 34 HPS patients (17 men, 17 women; mean age at diagnosis, 27±10 years) and 15 healthy controls. The clinical features of HPS patients including demographics, clinical history, laboratory, and ultrasonography findings were summarized. Serum IL-6 and IFN-γ levels were measured by using commercially available enzyme-linked immunosorbent assay kits. Gastrointestinal bleeding was the most common dominant presenting symptom. Majority of the patients had preserved liver function tests. Serum triglyceride levels were decreased in 30%. Abdominal ultrasonography revealed well-demarcated bands of increased echogenicity surrounding the portal vein wall and sudden narrowing of the intrahepatic second-degree portal vein branches in all cases. Spontaneous shunts and/or collaterals were seen in 13 cases (37%). Extrahepatic portal vein thrombosis were seen in 7 (20%) patients after at least 5 years of disease duration. Serum levels of both IL-6 (median, 3.2 pg/mL) and IFN-γ (median, 7.8 pg/mL) were significantly higher in HPS patients compared with the control group (median, 1 pg/mL). HPS has variable clinical profile in different geographic areas of the world. Both Th1 and 2 cells may have a role in the regulation of immune response and pathogenesis of the disease.
Literatur
1.
Zurück zum Zitat Sugimachi K (ed) (2001) Annual reports of the research committee on portal hemodynamics abnormalities, 1996–2000. Tokyo: Japan Ministry of Health and Welfare Sugimachi K (ed) (2001) Annual reports of the research committee on portal hemodynamics abnormalities, 1996–2000. Tokyo: Japan Ministry of Health and Welfare
2.
Zurück zum Zitat Sarin SK, Kapoor D (2002) Non-cirrhotic portal fibrosis: current concept and management. J Gastroenterol Hepatol 17:526–534PubMedCrossRef Sarin SK, Kapoor D (2002) Non-cirrhotic portal fibrosis: current concept and management. J Gastroenterol Hepatol 17:526–534PubMedCrossRef
3.
Zurück zum Zitat Inagaki H, Nonami T, Kawagoe T, Miwa T, Hosono J, Kurokawa T, Harada A, Nakao A, Takagi H, Suzuki H, Sakamoto J (2000) Idiopathic portal hypertension associated with systemic lupus erythematosus. J Gastroenterol 35:235–239PubMedCrossRef Inagaki H, Nonami T, Kawagoe T, Miwa T, Hosono J, Kurokawa T, Harada A, Nakao A, Takagi H, Suzuki H, Sakamoto J (2000) Idiopathic portal hypertension associated with systemic lupus erythematosus. J Gastroenterol 35:235–239PubMedCrossRef
4.
Zurück zum Zitat Hirasaki S, Koide N, Ogawa H, Wada T, Sato A, Ujike K, Tsuji T (1997) Mixed connective tissue disease associated with idiopathic portal hypertension and chronic thyroiditis. J Gastroenterol 32:808–811PubMed Hirasaki S, Koide N, Ogawa H, Wada T, Sato A, Ujike K, Tsuji T (1997) Mixed connective tissue disease associated with idiopathic portal hypertension and chronic thyroiditis. J Gastroenterol 32:808–811PubMed
5.
Zurück zum Zitat Watanabe Y, Mizukami T, Egawa T, Okamoto S, Sakauchi M, Takita T, Suzuki N, Sakuma M (1999) A case of progressive systemic sclerosis complicated by idiopathic portal hypertension with severe anemia. Ryumachi 39:586–590PubMed Watanabe Y, Mizukami T, Egawa T, Okamoto S, Sakauchi M, Takita T, Suzuki N, Sakuma M (1999) A case of progressive systemic sclerosis complicated by idiopathic portal hypertension with severe anemia. Ryumachi 39:586–590PubMed
6.
Zurück zum Zitat Morris JS, Htut T, Read AE (1972) Scleroderma and portal hypertension. Ann Rheum Dis 31:316–318PubMedCrossRef Morris JS, Htut T, Read AE (1972) Scleroderma and portal hypertension. Ann Rheum Dis 31:316–318PubMedCrossRef
7.
Zurück zum Zitat Saito K, Nakanuma Y, Takegoshi K, Ohta G, Obata Y, Okuda K, Kameda H (1993) Nonspecific immunological abnormalities and association of autoimmune diseases in idiopathic portal hypertension. A study by questionnaire. Hepatogastroenterology 40:163–166PubMed Saito K, Nakanuma Y, Takegoshi K, Ohta G, Obata Y, Okuda K, Kameda H (1993) Nonspecific immunological abnormalities and association of autoimmune diseases in idiopathic portal hypertension. A study by questionnaire. Hepatogastroenterology 40:163–166PubMed
8.
Zurück zum Zitat Tokushige K, Komatsu T, Ohzu K, Yamauchi K, Obata H (1992) A defective autologous mixed lymphocyte reaction in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 7:270–273PubMed Tokushige K, Komatsu T, Ohzu K, Yamauchi K, Obata H (1992) A defective autologous mixed lymphocyte reaction in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 7:270–273PubMed
9.
Zurück zum Zitat Tokushige K, Hirose S, Nishimura H, Fujimori M, Yamauchi K, Obata H, Futagawa S, Shirai T (1995) Abnormal T cell activation and skewed T cell receptor Vβ repertoire usage in Japanese patients with idiopathic portal hypertension. Clin Immunol Immunopathol 75:206–213PubMedCrossRef Tokushige K, Hirose S, Nishimura H, Fujimori M, Yamauchi K, Obata H, Futagawa S, Shirai T (1995) Abnormal T cell activation and skewed T cell receptor Vβ repertoire usage in Japanese patients with idiopathic portal hypertension. Clin Immunol Immunopathol 75:206–213PubMedCrossRef
10.
Zurück zum Zitat Yamaguchi N, Tokushige K, Haruta I, Yamauchi K, Hayashi N (1999) Analysis of adhesion molecules in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 14:364–369PubMedCrossRef Yamaguchi N, Tokushige K, Haruta I, Yamauchi K, Hayashi N (1999) Analysis of adhesion molecules in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 14:364–369PubMedCrossRef
11.
Zurück zum Zitat Murphy KM, Ouyang W, Farrar JD, Yang J, Ranganath S, Asnagli H, Afkarian M, Murphy TL (2000) Signaling and transcription in T helper development. Annu Rev Immunol 18:451–594PubMedCrossRef Murphy KM, Ouyang W, Farrar JD, Yang J, Ranganath S, Asnagli H, Afkarian M, Murphy TL (2000) Signaling and transcription in T helper development. Annu Rev Immunol 18:451–594PubMedCrossRef
12.
Zurück zum Zitat O’Garra A (1998) Cytokines induce the development of functionally heterogeneous T helper cell subsets. Immunity 8:275–283PubMedCrossRef O’Garra A (1998) Cytokines induce the development of functionally heterogeneous T helper cell subsets. Immunity 8:275–283PubMedCrossRef
13.
Zurück zum Zitat Macatonia SE, Hosken NA, Litton M, Vieria P, Hsieh CS, Culpepper JA, Wysocka M, Trinchieri G, Murphy KM, O’Garra A (1995) Dendritic cells produce IL-12 and direct the development of Th1 cells from naive CD4+ T cells. J Immunol 154:5071–5079PubMed Macatonia SE, Hosken NA, Litton M, Vieria P, Hsieh CS, Culpepper JA, Wysocka M, Trinchieri G, Murphy KM, O’Garra A (1995) Dendritic cells produce IL-12 and direct the development of Th1 cells from naive CD4+ T cells. J Immunol 154:5071–5079PubMed
14.
Zurück zum Zitat Liblau RS, Singer SM, McDevitt HO (1995) Th1 and Th2 CD4+ T cells in the pathogenesis of organ-specific autoimmune diseases. Immunol Today 16:34–38PubMedCrossRef Liblau RS, Singer SM, McDevitt HO (1995) Th1 and Th2 CD4+ T cells in the pathogenesis of organ-specific autoimmune diseases. Immunol Today 16:34–38PubMedCrossRef
15.
Zurück zum Zitat Seder RA, Paul WE, Davis MM (1992) The presence of interleukin 4 during in vitro priming determines the lymphokine-producing potential of CD4+ T cells from T cell receptor transgenic mice. J Exp Med 176:1091–1098PubMedCrossRef Seder RA, Paul WE, Davis MM (1992) The presence of interleukin 4 during in vitro priming determines the lymphokine-producing potential of CD4+ T cells from T cell receptor transgenic mice. J Exp Med 176:1091–1098PubMedCrossRef
16.
Zurück zum Zitat Ramalingaswamy B, Wig KL, Sama SK (1962) Cirrhosis of the liver in northern India. A clinicopathologic study. Arch Intern Med 110:350–358 Ramalingaswamy B, Wig KL, Sama SK (1962) Cirrhosis of the liver in northern India. A clinicopathologic study. Arch Intern Med 110:350–358
17.
Zurück zum Zitat Sarin SK, Sachdev G, Nanda R (1986) Follow-up of patients after variceal eradication. A comparison of patients with cirrhosis, non-cirrhotic portal fibrosis and extrahepatic obstruction. Ann Surg 202:78–82CrossRef Sarin SK, Sachdev G, Nanda R (1986) Follow-up of patients after variceal eradication. A comparison of patients with cirrhosis, non-cirrhotic portal fibrosis and extrahepatic obstruction. Ann Surg 202:78–82CrossRef
18.
Zurück zum Zitat Sama SK, Bhargava S, Nath NG, Talwar JR, Nayak NC, Tandon BN, Wig KL (1971) Non-cirrhotic portal fibrosis. Am J Med 51:160–169PubMedCrossRef Sama SK, Bhargava S, Nath NG, Talwar JR, Nayak NC, Tandon BN, Wig KL (1971) Non-cirrhotic portal fibrosis. Am J Med 51:160–169PubMedCrossRef
19.
Zurück zum Zitat Sarin SK (1989) Non-cirrhotic portal fibrosis. Gut 5:336–351 Sarin SK (1989) Non-cirrhotic portal fibrosis. Gut 5:336–351
20.
Zurück zum Zitat Dhiman RK, Chawla Y, Vasishta RK, Kakkar N, Dilawari JB, Trehan MS, Puri P, Mitra SK, Suri S (2002) Non-cirrhotic portal fibrosis (idiopathic portal hypertension): experience with 151 patients and a review of the literature. J Gastroenterol Hepatol 17:6–16PubMedCrossRef Dhiman RK, Chawla Y, Vasishta RK, Kakkar N, Dilawari JB, Trehan MS, Puri P, Mitra SK, Suri S (2002) Non-cirrhotic portal fibrosis (idiopathic portal hypertension): experience with 151 patients and a review of the literature. J Gastroenterol Hepatol 17:6–16PubMedCrossRef
21.
Zurück zum Zitat Okuda K, Kohno K, Ohnishi K, Kimura K, Omata M, Koen H, Nakajima Y, Musha H, Hirashima T, Takashi M (1984) Clinical study of 86 cases of idiopathic portal hypertension and comparison with cirrhosis with splenomegaly. Gastroenterology 86:600–610PubMed Okuda K, Kohno K, Ohnishi K, Kimura K, Omata M, Koen H, Nakajima Y, Musha H, Hirashima T, Takashi M (1984) Clinical study of 86 cases of idiopathic portal hypertension and comparison with cirrhosis with splenomegaly. Gastroenterology 86:600–610PubMed
22.
Zurück zum Zitat Hillaire S, Bonte E, Denninger M-H, Casadevall N, Cadranel J-F, Lebrec D, Valla D, Degott C (2002) Idiopathic non-cirrhotic intrahepatic portal hypertension in the West: a re-evaluation in 28 patients. Gut 51:275–280PubMedCrossRef Hillaire S, Bonte E, Denninger M-H, Casadevall N, Cadranel J-F, Lebrec D, Valla D, Degott C (2002) Idiopathic non-cirrhotic intrahepatic portal hypertension in the West: a re-evaluation in 28 patients. Gut 51:275–280PubMedCrossRef
23.
Zurück zum Zitat Habibullah CM, Rao GN, Murthy DK, Patmanabhan CG, Kumar N, Chandra V, Jayanarasimulu T, Naik S (1978) Non-cirrhotic portal fibrosis in Andhra Pradesh (clinical, radiological, biochemical, hemodynamic and histologic aspects). J Assoc Physicians India 26:379–382PubMed Habibullah CM, Rao GN, Murthy DK, Patmanabhan CG, Kumar N, Chandra V, Jayanarasimulu T, Naik S (1978) Non-cirrhotic portal fibrosis in Andhra Pradesh (clinical, radiological, biochemical, hemodynamic and histologic aspects). J Assoc Physicians India 26:379–382PubMed
24.
Zurück zum Zitat Okuda K (1984) Idiopathic portal hypertension. Gastroenterol Jpn 19:74–82 Okuda K (1984) Idiopathic portal hypertension. Gastroenterol Jpn 19:74–82
25.
Zurück zum Zitat Vakili C, Farahvash MJ, Bynum TE (1992) ‘Endemic’ idiopathic portal hypertension. Report on 32 patients with non-cirrhotic portal fibrosis. World J Surg 16:118–125PubMedCrossRef Vakili C, Farahvash MJ, Bynum TE (1992) ‘Endemic’ idiopathic portal hypertension. Report on 32 patients with non-cirrhotic portal fibrosis. World J Surg 16:118–125PubMedCrossRef
26.
Zurück zum Zitat Tandon BN, Nundy S, Nayak NC (1983) Non-cirrhotic portal hypertension in Northern India. Clinical features and liver function tests. In Okuda K, Omata M (eds) Idiopathic Portal Hypertension. Tokyo, University of Tokyo Pressl; pp 377–386 Tandon BN, Nundy S, Nayak NC (1983) Non-cirrhotic portal hypertension in Northern India. Clinical features and liver function tests. In Okuda K, Omata M (eds) Idiopathic Portal Hypertension. Tokyo, University of Tokyo Pressl; pp 377–386
27.
Zurück zum Zitat Bernard PH, Le Bail B, Cransac M, Barcina MG, Carles J, Balabaud C, Bioulac-Sage P (1995) Progression from idiopathic portal hypertension to incomplete septal cirrhosis with liver failure requiring liver transplantation. J Hepatol 22:495–499PubMedCrossRef Bernard PH, Le Bail B, Cransac M, Barcina MG, Carles J, Balabaud C, Bioulac-Sage P (1995) Progression from idiopathic portal hypertension to incomplete septal cirrhosis with liver failure requiring liver transplantation. J Hepatol 22:495–499PubMedCrossRef
28.
Zurück zum Zitat Iannello S, Cavaleri A, Camuto M, Pisano MG, Milazzo P, Belfiore F (2002) Low fasting serum triglyceride and high free fatty acid levels in pulmonary fibrosis: a previously unreported finding. MedGenMed 4:5PubMed Iannello S, Cavaleri A, Camuto M, Pisano MG, Milazzo P, Belfiore F (2002) Low fasting serum triglyceride and high free fatty acid levels in pulmonary fibrosis: a previously unreported finding. MedGenMed 4:5PubMed
29.
Zurück zum Zitat Iannello S, Cavaleri A, Milazzo P, Cantarella S, Belfiore F (2003) Low fasting serum triglyceride level as a precocious marker of autoimmune disorders. MedGenMed 5:20PubMed Iannello S, Cavaleri A, Milazzo P, Cantarella S, Belfiore F (2003) Low fasting serum triglyceride level as a precocious marker of autoimmune disorders. MedGenMed 5:20PubMed
30.
Zurück zum Zitat Svenson KL, Lithell H, Hallgren R, Selinus I, Vessby B (1987) Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides. I. Relativity to inflammatory activity. Arch Intern Med 147:1912–1916PubMedCrossRef Svenson KL, Lithell H, Hallgren R, Selinus I, Vessby B (1987) Serum lipoprotein in active rheumatoid arthritis and other chronic inflammatory arthritides. I. Relativity to inflammatory activity. Arch Intern Med 147:1912–1916PubMedCrossRef
31.
Zurück zum Zitat Kuroki T (1990) Analysis of IFN-γ production in the patients with idiopathic portal hypertension. In: Obata H (ed) 1989 Report of the Ministry of Health and Welfare Research Committee on Disease with Abnormal Portal Hemodynamics. Tokyo, Ministry of Health and Welfare, pp 67–69 Kuroki T (1990) Analysis of IFN-γ production in the patients with idiopathic portal hypertension. In: Obata H (ed) 1989 Report of the Ministry of Health and Welfare Research Committee on Disease with Abnormal Portal Hemodynamics. Tokyo, Ministry of Health and Welfare, pp 67–69
32.
Zurück zum Zitat Tokushige K, Yamauchi K, Komatsu T, Takasaki K, Hayashi N (2000) Predominant T helper 1 cells in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 15:1312–1317PubMedCrossRef Tokushige K, Yamauchi K, Komatsu T, Takasaki K, Hayashi N (2000) Predominant T helper 1 cells in patients with idiopathic portal hypertension. J Gastroenterol Hepatol 15:1312–1317PubMedCrossRef
33.
Zurück zum Zitat Diehl S, Rincon M (2002) The two faces of IL-6 on Th1/Th2 differentiation. Mol Immunol 39:531–536PubMedCrossRef Diehl S, Rincon M (2002) The two faces of IL-6 on Th1/Th2 differentiation. Mol Immunol 39:531–536PubMedCrossRef
34.
Zurück zum Zitat Gajewski TF, Renauld JC, Van Peel A, Boon T (1995) Costimulation with B7-1, IL-6, and IL-12 is sufficient for primary generation of murine antitumor cytolytic T lymphocytes in vitro. J Immunol 154:5637–5648PubMed Gajewski TF, Renauld JC, Van Peel A, Boon T (1995) Costimulation with B7-1, IL-6, and IL-12 is sufficient for primary generation of murine antitumor cytolytic T lymphocytes in vitro. J Immunol 154:5637–5648PubMed
35.
Zurück zum Zitat Tilg H, Dinarello C, Mier J (1997) IL-6 and APPs: anti-inflammatory and immunosuppressive mediators. Immunol Today 18:428–432PubMedCrossRef Tilg H, Dinarello C, Mier J (1997) IL-6 and APPs: anti-inflammatory and immunosuppressive mediators. Immunol Today 18:428–432PubMedCrossRef
36.
Zurück zum Zitat Mwatha JK, Kimani G, Kamau T, Mbugua GG, Ouma JH, Mumo J, Fulford AJ, Jones FM, Butterworth AE, Roberts MB, Dunne DW (1998) High levels of TNF, soluble TNF receptors, soluble ICAM-1 and IFN-γ, but low levels of IL-5 are associated with hepatosplenic disease in human Schistosomiasis mansoni. J Immunol 160:1992–1999PubMed Mwatha JK, Kimani G, Kamau T, Mbugua GG, Ouma JH, Mumo J, Fulford AJ, Jones FM, Butterworth AE, Roberts MB, Dunne DW (1998) High levels of TNF, soluble TNF receptors, soluble ICAM-1 and IFN-γ, but low levels of IL-5 are associated with hepatosplenic disease in human Schistosomiasis mansoni. J Immunol 160:1992–1999PubMed
Metadaten
Titel
Clinical Features, Serum Interleukin-6, and Interferon-γ Levels of 34 Turkish Patients With Hepatoportal Sclerosis
verfasst von
Aydın Şeref Köksal
Seyfettin Köklü
Mehmet İbiş
Mustafa Balcı
Bahattin Çiçek
Nurgül Şaşmaz
Burhan Şahin
Publikationsdatum
01.12.2007
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 12/2007
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-006-9596-0

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