Study On The Relationship Betweeen Concentations Of Endotoxin, TNF-α, IL-6in Serum And The Severity Of Hepatitis B

Objective The concentrations of endotoxin (LPS), tumor necrosis factor (TNF-α) andinflammatory cytokines-6(IL-6) in serum of patients with severe hepatitis B weredetected, and compared with the chronic hepatitis B and control, so to explore their rolesin the severity of Hepatitis B and their mutual relations, then to provide theoretical andclinical basis for the clinical treatment and predication of chronic hepatitis.Methods120cases of hospitalized patients and healthy subjects were taken fromTangshan Infectious Diseases Hospital from June2012to October2013, including40cases of chronic severe hepatitis B patients (34male and6female), age from22to44years (with the average age of33.4±12.0years),40patients with chronic hepatitis B (33maleand7female), age from26to48years (with the average age of36.1±8.3years)and40cases of non-B hepatitis patients (healthy) for the normal control group (35maleand5female), age from25to46years (with the average age of35.3±10.2years).Fasting blood were collected in the morning before any treatment, then total bilirubin(TBil) and alanine aminotransferase (ALT) were detected, so were LPS, TNF-α, and IL-6in all case. LPS lever was measured by chromogenic limulus mebocyte lysate test(LAL),TNF-α and IL-6were measured by enzyme linked immunosorbent assay (ELZSA). Datawas analysed by SPSS13.0statistical software. Measurement data were expressed asmean±standard deviation (x s), and analysis of variance was adpoted. Pearsonproduct moment correlation analysis were used to analyze the relationships between theconcentrations of endotoxin, cytokines and the prognosis of patients.Results1ALT and TBil levels in patients with hepatitis B were significantly higherthan those of healthy control (P<0.05), and their levels in patients with chromic severehepatitis B were extremely higher than those with chromic hepatitis B (P<0.05).2LPS,TNF-α and IL-6levels in patients with hepatitis B were significantly higher than those ofhealthy control (P<0.05), and their levels in patients with chromic severe hepatitis B wereextremely higher than those with chromic hepatitis B (P<0.05).3There is no significantrelativity between the level of ALT and endotoxin, TNF-α, IL-6in chronic severehepatitis B patients.4The concentration of TNF-α increased according with that of LPSin patients with chromic severe hepatitis B, they were closely related(rLPS-TNF-α=0.358 P<0.005). Besides, serum concentration of IL-6increased according with that of LPS inpatients with chromic severe hepatitis B, they also had relationship (rLPS-IL-6=0.344P<0.005).5There was significant relativity between the levesl of endotoxin, TNF-α, IL-6and the prognosis of chronic severe hepatitis B patients.Conclusion The liver function in patients with chronic severe hepatitis B wassignificantly impaired. The increasment of endotoxin may be one of the important causesin the process of severe chronic hepatitis B, and the increasment of TNF-α and IL-6mediated by endotoxin may be one of the important mechanisms. The detection ofendotoxin, TNF-α and IL-6was likely to be useful index in the predication of chromicseverity hepatitis B.