HIGH-LEVELS OF TUMOR-NECROSIS-FACTOR-ALPHA AND INTERLEUKIN-6 IN THE ASCITIC FLUID OF CIRRHOTIC-PATIENTS WITH SPONTANEOUS BACTERIAL PERITONITIS

We prospectively measured the concentrations of immunoreactive tumor n ecrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), and interleuki n-6 (IL-6) in the serum and ascitic fluid of 14 alcoholic cirrhotic pa tients with spontaneous bacterial peritonitis (SBP) and 16 alcoholic c irrhotic patients with sterile ascitic fluid. TNF-alpha levels in asci tic fluid were significantly higher for the patients with SBP: 399.57 +/- 129.23 pg/mL vs. 35.76 +/- 5.57 pg/mL (P < .001). IL-6 levels in a scitic fluid were also significantly higher for the patients with SBP: 170,713 +/- 57,109 ng/mL vs. 5,414 +/- 973 ng/mL (P < .001). By contr ast, serum levels of TNF-alpha and IL-6 were just slightly more elevat ed than normal values. The concentration of IL-1 in the ascitic fluid of all patients was elevated, but there was no difference between pati ents with SBP or sterile ascites in this respect. In the patients with SBP, levels of TNF-alpha and IL-6 in ascitic fluid decreased during t he first 48 hours of antibiotic treatment. Our results suggest that me asurements of TNF-alpha and IL-6 in ascitic fluid may become useful ma rkers both for the diagnosis of SBP and for monitoring the treatment o f cirrhotic patients.