Changes in serum levels of interleukin-32 and interleukin-10 and their clinical significance in patients with HBV-related acute-on-chronic liver failure

ObjectiveTo investigate the changes in the serum levels of interleukin-32 (IL-32) and interleukin-10 (IL-10) and their clinical significance in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF). MethodsA total of 38 HBV-ACLF patients who were hospitalized and treated in The First Affiliated Hospital of Soochow University from September 2012 to March 2014 were enrolled as HBV-ACLF group, as well as 20 patients with chronic hepatitis B (CHB) (CHB group) and 20 healthy controls (healthy control group). ELISA was used for dynamic monitoring of the changes in the serum levels of IL-32 and IL-10. The serum levels of IL-32 and IL-10 were compared between early-, middle-, and late-stage HBV-ACLF groups, between infection group and non-infection group, and between survival group and death group. The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups. ResultsCompared with the CHB group and the healthy control group, the HBV-ACLF group had significantly higher levels of IL-32 (50098±152.33 pg/ml vs 281.72±99.28 pg/ml and 178.16±50.54 pg/ml, both P＜0.05) and IL-10 (4.82±1.03 pg/ml vs 3.15±0.98 pg/ml and 1.62±0.43 pg/ml, both P＜0.05). Dynamic monitoring of IL-32 level in the HBV-ACLF group showed that the early-stage HBV-ACLF group had a significantly higher level than the middle-stage HBV-ACLF group (540.69±155.71 pg/ml vs 498.43±135.56 pg/ml, P＜0.05), and the middle-stage HBV-ACLF group had a significantly higher level than the late-stage HBV-ACLF group (498.43±135.56 pg/ml vs 450.77±102.33 pg/ml, P＜0.05); as for the level of IL-10, the early-stage HBV-ACLF group had a significantly lower level than the middle-stage HBV-ACLF group (1.94±0.44 pg/ml vs 2.83±0.97 pg/ml, P＜0.05), and the middle-stage HBV-ACLF group had a significantly lower level than the late-stage HBV-ACLF group (2.83±0.97 pg/ml vs 3.69±123 pg/ml, P＜0.05). The HBV-ACLF infection group had a significantly higher level of IL-32 than the non-infection group (553.41±158.65 pg/ml vs 48254±110.16 pg/ml, P=0.021). Compared with the HBV-ACLF death group, the HBV-ACLF survival group had a significantly lower level of IL-32 (481.95±100.67 pg/ml vs 540.62±112.45 pg/ml, P=0.011) and a significantly higher level of IL-10 (4.21±1.27 pg/ml vs 3.61±1.05 pg/ml, P=0.038). ConclusionThe cytokine network plays an important role in the pathogenesis of HBV-ACLF. Serum IL-32 and IL-10 may be involved in disease progression, and dynamic monitoring of their levels helps with prognostic prediction