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). AF samples were examined for leucocytic count and differentiation, lymphocyte surface markers (CD3, CD4, CD8), albumin, protein, glucose, density, PH, and serum-ascitic albumin gradient. Bacterial culture within BACTEC blood culture bottles was done for all patients. Serum and AF levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured for all patients.
Results: Lower CD4,CD4/CD8 ratio and higher CD8 were detected in patients with SBP. By multivariate analysis , high serum and AF IL-6 was significant predictor of SBP(p=0.028).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 marker 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. |
