Plasma Interleukin-10: A Likely Predictive Marker for Hepatitis B Virus-Related Acute-on-Chronic Liver Failure

Background: the pathogenesis of hbv-related acute-on-chronic liver failure (hbv-aclf) is mainly based on a heightened immune-inflammatory reaction; however, the intimate underlying mechanism remains unclear. objectives: the aim of the study was to explore potential key immune molecular targets that could serve as early predictive markers for hbv-aclf. patients and methods: twenty-seven patients with acute exacerbation of chronic hepatitis b (chb) (defined by: alanine transaminase ≥ 20 uln, total bilirubin ≥ 5 uln, 40% < prothrombin time activity ≤ 60%) and without cirrhosis were divided into 18 cases which did not progress to hbv-aclf (defined by: prothrombin time activity < 40% and development within four weeks of hepatic encephalopathy and/or ascites) and nine cases that developed hbv-aclf. nine healthy people defined the normal control group (nc). interleukin-1β (il-1β), il-2, il-4, il-6, il-8, il-10, il-12p70, tnf-α and ifn-γ protein levels were assayed by cytometric bead array (cba) in blood plasma. the elisa method was applied to confirm il-10 detection using the cba method. results: il-4, il-12p70 and ifn-γ were undetectable; il-1β, il-6, il-8, il-10 and tnf-α levels were significantly higher than in nc. moreover, cytokines reached the highest levels in acute exacerbation of chb, with the exception of il-2 and il-8. when comparing the hbv-aclf patients prior to and at the time of aclf diagnosis, il-10 was the only cytokine that exhibited a significant decrease (p = 0.008). il-10 concentrations were positively correlated to alt levels (r = 0.711, p < 0.001). conclusions: the assessment of plasma il-10 levels in chronic hepatitis b acute exacerbation may provide an early predictive marker for progression to hbv-aclf.