IL-37 correlates with MELD Score & thrombocytopenia in patients with liver cirrhosis

Background:

IL37 is expressed in various tissues and is regulated by inflammatory stimuli and cytokines via distinct signal transduction pathways. Recently, IL37 expression was found to be increased in a variety of cancer cells, chronic inflammatory- and autoimmune disorders, and herein exerts mainly antiinflammatory effects. It therefore plays a crucial role in inhibiting both, innate and adaptive immune responses, as well as inflammatory reactions.

Methods:

We studied 309 patients diagnosed with liver cirrhosis, based on different underlying conditions, and 22 healthy volunteers. MELD score and Child Pugh score was calculated and the cohort size was almost equally distributed within the ranges of MELD scores and Child Pugh scores. Our cohort comprised of 167 patients with liver cirrhosis Child Pugh A, 72 with Child Pugh B, and 70 with Child Pugh C. The IL-37 serum levels were quantified with an ELISA and were correlated to MELD, Child Pugh Score, C-reactive protein (CRP), creatinine and platelet counts.

Results:

IL-37 serum levels showed a highly significant positive correlation with MELD Score (r = 0,24; p < 0.0001) and the Child Pugh score (r = 0,42; p < 0.0001). Furthermore, IL-37 serum levels negatively correlated with platelet counts (r =-0,25; p < 0.0001). There was only a slight positive correlation with CRP values (r = 0,13; p = 0.0152) but no correlation with serum creatinine (r = 0,01; p = 0,768).

Conclusion:

IL-37, a major anti-inflammatory and IL-1 neutralizing cytokine reflects an independent marker of severity of liver cirrhosis. Despite increased levels, endogenous anti-inflammatory strategies fail to compensate for the overwhelming pro-inflammatory tone of advanced liver diseases.