Analysis Of Correlation Between Clinicopathological Features And Cytokines In 32 Patients With Drug-induced Liver Injury

AIM:In this study,we aim to investigate the changes of cytokine expression in DILI and to evaluate the correlation between cytokine expression and clinicopathological characteristics in DILI,so as to predict and evaluate the development of the disease.Objectives and method:(1)Objectives: From April 2016 to April 2018,159 patients with drug-induced liver injury diagnosed by liver biopsy in our hospital were selected as experimental subjects,and 32 patients with relatively complete clinical data were selected as experimental group.The 32 patients were defined as G1,G2,G3 and G4 groups according to the degree of inflammation shown by pathology(the degree of inflammation increased in turn).Four healthy persons were randomly selected and defined as normal group(group N).(2)Method: Summarize the clinical,laboratory,pathological and prognostic characteristics of 32 patients.The laboratory indicators were grouped according to the type of liver injury.Statistical analysis was carried out using SPSS20.0 statistical software.Non-normal distribution data were expressed by median and quartile spacing.Kruskal-Wallis test was used for multi-group non-parametric statistics.When P<0.05,it was considered that there was statistical significance.In addition,the serum of 32 patients and the serum of 4 control groups stored in the-80℃ specimen library of our pathology department were collected,and the expression of cytokines was detected by high-throughput protein immunoassay technology,namely QAH-INF-3 chip.Results:(1)Analysis of clinical characteristics: The DILI population was composed of 10 males(44.2 +15.24 years old)and 22 females.(50.14+11.22 years old).The liver injury patterns represented among the cases were hepatocellular(68.75%),cholestasis(18.75%),and mixed hepatocellularcholestatic(12.5%)respectively.Traditional Chinese medicine(56.25%)were the most common cause of DILI,followed by the dietary supplement(12.5%)and antimicrobials(9.38%).(2)Pathological Characteristics: Within our patient population,the major change in liver pathology was watery degeneration.The remaining pathological changes mainly include different degrees of interfacial inflammation and small bile duct hyperplasia,Kupffer cell infiltration,intrahepatic cholestasis and so on.(3)Prognosis: Four people were hospitalized repeatedly.One of them gradually progressed to liver failure and eventually died within 3 months.One person rapidly progressed to decompensated cirrhosis within six months and then liver transplantation.The other patients responded well to the treatment.(4)Cytokines: Compared with the normal control group,the expression of cytokines in patients with drug-induced liver injury is different.Conclusion:The serum levels of many cytokines in patients with drug-induced liver injury were higher than those in the control group,such as TNF-a,MCP-1,MIP-1a,G-CSF,IL-1beta,IL-8,etc.The distribution of these cytokines in different inflammation grades of liver injury was often different.These cytokines play an important role in the occurrence and development of drug-induced liver injury.We can define drug-induced liver injury more accurately by measuring the level of cytokines.