Relation of Lymphocyte Subsets and Cytokines in Different Grades of Alcoholic Cirrhosis
Published: January 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/39593.12489
Archana Chirag Buch, Amardeep Patil, Niladri Haldar, Banyameen Iqbal, Dakshayani Pandit, Arjun Lal Kakrani, Sunita Bamanikar, Harsh Kumar
1. Professor, Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
2. Resident, Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
3. Resident, Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
4. Associate Professor, Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
5. Professor, Department of Microbiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
6. Professor, Department of Medicine, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
7. Professor, Department of Pathology, Dr. D.Y. Patil
Correspondence
Dr. Niladri Haldar,
Department of Pathology, Dr. DY Patil Medical College, Sant Tukaram Nagar, Pimpri, Pune-411018, Maharashtra, India.
E-mail: haldar.niladri@gmail.com
Introduction: The pathogenesis of Alcoholic Liver Disease (ALD) shows immune dysregulation with decreasing lymphocyte subsets and increasing CD4/CD8 ratio. T lymphocyte activation leads to secretion of cytokines like Tumour Necrosis Factor-a (TNF-a) and interleukins causing inflammation and fibrosis.
Aim: To correlate lymphocyte subsets and TNF-a and Interleukin 6 (IL-6) in different grades of alcoholic cirrhosis.
Materials and Methods: This was a prospective, cross-sectional study carried out over a period of two years at a tertiary care hospital and research centre in Western Maharashtra. The study cohort consisted of 51 patients diagnosed clinically as alcoholic cirrhosis. They were classified into grades A, B and C by Child-Pugh’s score. Lymphocyte subsets were determined by flow cytometry. T lymphocytes were identified (CD3+), and further subdivided into CD4+and CD8+cells. TNF-a and IL-6 were measured by ELISA. All parameters were measured using one-way Analysis of Variance (ANOVA test).
Results: There was insignificant change in the total number of lymphocytes with different grades of cirrhosis. T lymphocytes and CD4+cells showed increase in count (885.38±464.19/mm3 to 1002.81±338.52/mm3) and (489.63±248.23/mm3 to 689.05±263.08/mm3) respectively, with corresponding decrease in CD8 count (364±230.37 to 3440.38±165.91). There was also an increase in CD4/CD8 ratio (1.48 to 2.18) along with raised TNF-a (25.16±18.45 to 30.15±36.37) and IL-6 (58.27±50.52 to 175.38±241.85) with increasing grades of cirrhosis.
Conclusion: Alcoholic cirrhosis is a complex entity caused due to interaction between various components of immune systems and elaboration of cytokines. We found increase in T lymphocytes and CD4+cells along with increase in cytokines TNF-a and IL-6 with increase in grades of cirrhosis.
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