Correlation of high levels of hyaluronan and cytokines (IL-1 beta, IL-6, and TGF-beta) in ascitic fluid of cirrhotic patients

Our objective was to investigate the relationship between endotoxin and hya luronan synthesis and release in serum and ascitic fluid from cirrhotic pat ients. We studied hyaluronan, endotoxin, albumin, and creatinine levels in ascitic fluid and plasma and cytokine levels (IL-1 beta, IL-6, TGF-beta) in ascitic fluid. TGF-beta, IL-6, and IL-1 beta correlation analyses indicate d a strong dependence of the production of these cytokines on endotoxin lev els. Correlation analyses for TGF-beta and IL-6 indicated a strong dependen ce of the production of hyaluronan on cytokine levels and, to a lesser exte nt, on IL-1 beta levels. Hyaluronan analysis indicated that a certain glyco saminoglycan level is required in ascites before its appearance in plasma. Our results disclosed elevated plasma hyaluronan concentrations. The simult aneous increased hyaluronan levels in ascitic fluid do not seem to be deriv ed from the systemic circulation. In conclusion, the high hyaluronan-ascite s/hyaluronan-plasma ratio suggests an intrinsic hyaluronan production from peritoneal cells induced by endotoxins.