ABSTRACT
This study was designed to assess leptin changes in serum and ascitic fluid of patients with decompensated cirrhosis and clarify if it plays a role in the pathogenesis of SB and relation of this role- if any-to TNF alpha in those patients 30 subjects were included in the study; 10 healthy control, 10 cirrhotic patients with sterile ascites, and 10 with spontaneous bacterial peritonitis [SBP]. All participants were subjected to full clinical examination, and a range of laboratory test. ELISA test was used to assess levels of leptin and TNF alpha both in serum and ascitic fluid. The results show elevation of serum and ascitic fluid leptin and TNF alpha in cirrhotic cases versus control, with ascitic/serum ratio > 1 suggesting intra abdominal production of both cytokines. Both serum and ascitic fluid leptin and TNF alpha were significantly higher in patients with SBP than those with sterile ascites and were positively correlated. Our results suggest elevation of serum and ascitic fluid leptin to play an immunological role in pathogenesis of SBP, and TNF alpha to be a putative candidate involved in this mechanism