Ascitic fluid lymphocyte subgroups and cytokine levels of decompensated liver cirrhotic patients having spontaneous bacterial peritonitis

Background and aim: Spontaneous ascites infection is a frequently encountered and important complication of decompensated liver cirrhosis. The immune system plays an important role in the development or eradication of this infection. A number of compositional and functional alterations in immune system cells have been demonstrated in cirrhotic patients; however, there is a lack of knowedge about this issue in ascitic infections. The aim of the present study was to evaluate lymphocyte subsets and levels of some ascitic cytokines in decompensated cirrhotic patients with or without spontaneous ascites infection.Material and Method: Fourty-one patients with chirrosis with different etiology (30 were male and 11 were female) were included into the study. Positive ascite fluid culture and/or polymorphonuclera cells ? 250/mm3 considered as infected group, and positive ascite fluid culture was considered as culture positive group. White blood cell count, total protein, albumin levels, serum ascite albumin gradient, lymphocytes subgroups (CD3, CD4, CD8, CD16, CD19, CD56, CD4/CD8 ratio), IL?6, IL?8, IL-l0 and TNF-? levels of ascites were evaluated. The results of infected patients were compared with non-infected patients, and also culture positive patients with culture negative patients.Results: CD4 + lymphocyte count and CD4/CD8 ratio were signiticantly lower in infected patients as compared in non-infected patient group. There were no statistically significant difference between patients with culture positive and negative patients in terms of lymphocyte count and CD4/CD8 ratio. Ascite IL?8 and TNF-? levels were statistically significantly higher in infected and culture positive patients as compared with non-infected and culture negative groups.Conclusion: Cellular immunity play a central role in ascitic fluid infections in patients with decompensated hepatic cirrhosis. Our results of CD4/CD8 ratio was lower in patients with infected ascite, and Th 1 (T hepler-l) related cytokines (IL?8, TNF-?) were higher in patients with infected and culture positive ascite were agreed with aforementioned theory.Key Words: Liver cirrhosis, spontaneous bacterial peritonitis, lymphocyte subgroups, cytokines.