Serum level of tumor necrosis factor-alpha in patients with hepatic encephalopathy due to chronic liver diseases

Tumor necrosis factor-alpha [TNF-alpha] is involved in many acute and chronic liver disease [CLD]. This work was conducted on 69 patients with CLD [50 patients with overt hepatic encephalopathy [HE] and 19 patients with no evidence of HE] and 13 healthy subjects as a control group. The aim was to assess the serum level TNF-alpha in patients with HE due CLD and to correlate this level with the severity and precipitating factors of HE. All patients and control subjects were subjected to clinical, laboratory and abdominal ultrasonography in addition to measurement of serum level of TNF-alpha. HE was more common in male patients [P<0.002] but not related to the age [P = 0.826]. Serum TNF- alpha level was significantly elevated in patients with CLD in comparison with the control and patients with overt HE than those with no evidence of HE [16.88 pg/ml. 33.85 pg/ml and 78.48 pg/ml] respectively. TNF-alpha was positively correlated to the synthetic liver function but not related to the liver enzyme levels. TNF-alpha was positively related to the severity of liver disease represented by Child-Pugh score [P<0.001] being highest in Child C patients. The serum level of TNF-alpha was significantly correlated to the severity of HE reaching its highest levels in Grade IV. but not related to the precipitating factors of HE. serum level of TNF-alpha was higher in cirrhotic patients with HE and correlates with severity but not the precipitating factors of HE

study of serum tumor necrosis factor-alpha in patients with chronic viral hepatitis

Recent advances in molecular medicine have focused attention on cyto-kines in the machinery of inflammation and immune response. Tumor necrosis factor [TNF-alpha] is a cytokine produced primarily by activated mono-cytes and lymphocytes. that posses pleiotropic properties. TNF-alpha has been involved in the pathogenesis of diversity of liver diseases including viral hepatitis. The aim of this study was to investigate a group of patients with histologically documented chronic viral hepatitis for the level of serum TNF-alpha with particular attention to its correlation with disease activity. Thirty patients with biopsy-proven chronic Viral hepatitis and ten healthy controls were studied in this work. Cases included 25 males and 5 females with an age range of 23 to 67 years. Controls included 8 males and 2 females with an age range of 25 to 60 years. Cases were classified into three groups: Group I consisted of 6 cases with chronic hepatitis B, Group II 14 cases with chronic hepatitis C and Group III 10 cases with evidence of combined B and C viral infections. Results revealed that serum TNF alpha levels were significantly increased among patients with chronic viral hepatitis compared to controls. TNF alpha significantly correlated with the severity of the activity of viral infection as gauged by the histological activity index [HAI]. There was. however, no statistically significant difference between the three groups of cases and each other. It was concluded that TNF alpha is a better measure of disease activity than conventional bio chemical liver function tests. Moreover monitoring of TNF alpha along with ALT during treatment might provide more precise information of effectiveness of therapy