Expression of proinflammatory cytokines and their inhibitors during the course of spontaneous bacterial peritonitis

The aim of this work was the evaluation, in cirrhotic patients with noninfe cted ascites and with spontaneous bacterial peritonitis (SBP), of serum and ascitic fluid levels of proinflammatory cytokines [interleukin (IL) 1-beta , tumor necrosis factor alpha (TNF-alpha), and IL6] and antiinflammatory co mpounds [ILIO, soluble IL-I receptor antagonist (sIL-1Ra), soluble receptor s of TNF p55 and p75 (sTNFR55 and sTNFR75), and soluble receptor of IL6 (sI L6R)], as well as their relationship with the outcome of the infection in t hose with SBP. These molecules were assayed by ELISA in noninfected cirrhot ic controls (n = 15), patients with SBP (n = 32), and healthy controls (n = 20). Serum levels of IL6 and of the majority of antiinflammatory mediators , sIL1Ra, sTNFR75, and sIL6R, were higher in control cirrhotic patients com pared to healthy subjects. SBP was associated with significantly elevated a scitic fluid levels of every one of the proinflammatory cytokines compared to those in cirrhotic controls. Also, serum levels of IL10 and both TNF rec eptors and ascitic fluid levels of sIL1 Ra and sTNFR55 were higher in patie nts with SBP compared to cirrhotic controls. Ascitic fluid levels of proinf lammatory cytokines decreased rapidly after resolution of the infection; ho wever, nonsignificant changes were detected in ascitic fluid concentrations of antiinflammatory molecules. Thus, elevated levels of antiinflammatory c ompounds both in noninfected cirrhotic patients and in patients with SBP su ggest a regulatory control of the inflammatory process by these molecules i n liver cirrhosis patients.