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001-es BibID:	BIBFORM063221
Első szerző:	Tornai Tamás István (belgyógyász)
Cím:	Macrophage activation marker, soluble CD163 is an independent predictor of short-term mortality in patients with cirrhosis and bacterial infection / Tornai Tamas, Vitalis Zsuzsanna, Sipeki Nora, Dinya Tamas, Tornai David, Antal-Szalmas Peter, Karanyi Zsolt, Tornai Istvan, Papp Maria
Dátum:	2016
ISSN:	1478-3223
Megjegyzések:	BACKGROUND&AIMS: Innate immune system dysfunction is common in advanced cirrhosis, with a central role of the monocyte/macrophage system. Monocytes and macrophages express the scavenger receptor CD163 which is regulated by inflammatory mediators. Cleavage of the receptor leads to formation of soluble (s)CD163, that represents anti-inflammatory response. We aimed to study the clinical importance of sCD163 in cirrhosis.METHODS:Sera of 378 patients were assayed for sCD163 by ELISA (193 outpatients and 185 patients with acute decompensation[AD]). A 5-year follow-up observational study was conducted to assess the possible association between sCD163 level and poor disease outcomes.RESULTS: sCD163 level was associated with disease severity, but not with the presence of varices or prior variceal bleeding. In outpatients, sCD163 level did not predict the development of disease-specific complications or the long-term mortality. In patients with AD episode, sCD163 level was significantly higher compared to outpatients but only in the presence of bacterial infection[INF] (AD-INF:4586, AD-NON-INF:3792 and outpatients: 3538ng/mL, p<0.015 and p=0.001, respectively). sCD163 level gradually increased according to severity of infection. During bacterial infections, high sCD163 level(>7000ng/mL) was associated with increased mortality rate (42% vs. 17%, p<0.001) and was identified as an independent predictor of 28-day mortality (HR:2.96, 95%CI:1.27-6.95) in multivariate Cox-regression model comprising etiology, co-morbidity, MELD score and leukocyte count as covariates.CONCLUSIONS:High sCD163 level is useful to identify patients with high-risk of death during an AD episode complicated by bacterial infection. This finding serves as an additional hint towards the significance of anti-inflammatory response during bacterial infection. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban sCD163 cirrhosis anti-inflammatory response
Megjelenés:	Liver International 36 : 11 (2016), p. 1628-1638. -
További szerzők:	Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Sipeki Nóra (1987-) (általános orvos) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Karányi Zsolt (1961-) (biostatisztikus, bioinformatikus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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