NEUTROPHIL ACTIVATION IN CHRONIC LIVER-DISEASE

Objective To assess the relationship between neutrophil activation and indices of disease severity in patients with chronic liver disease. M ethods: Plasma neutrophil elastase was measured by radioimmunoassay as a marker of neutrophil activation, and disease severity assessed by s tandard clinical, biochemical, haematological and histological techniq ues. Patients: Eighty-eight patients with chronic liver disease were s tudied. Thirty-nine had alcohol-induced liver disease (ALD), 18 autoim mune chronic hepatitis, 13 cryptogenic cirrhosis, seven primary biliar y cirrhosis, six primary sclerosing cholangitis, three haemochromatosi s and two secondary biliary cirrhosis. Seventy three patients were cir rhotic and 15 were non-cirrhotic, confirmed by biopsy. Results: Levels of neutrophil elastase were raised in Childs C cirrhotic patients wit h ALD compared with Childs A or B patients with ALD (P<0.01), Childs A or B patients with non-ALD (P<0.01), and Childs C patients with non-A LD (P=0.02). In patients with ALD, neutrophil elastase correlated with prothrombin time (r=0.679, P=0.001), bilirubin (r=0.587, P<0.001), Ch ild-Pugh score (r=0.546, P< 0.001) and inversely with serum albumin (r =-0.511, P<0.001). In patients with non-ALD, there were no correlation s with these measurements or with transaminase levels. Conclusion: Neu trophil activation, as measured by plasma neutrophil elastase, is a ma rker of disease severity in patients with alcohol-induced chronic live r damage, but not in those with other causes of liver disease.