Correlation between serum interleukin-1 receptor antagonist and disease severity in patients with HBV-related liver failure

Objective To investigate the correlation between serum interleukin- 1 receptor antagonist( IL- 1Ra) level and disease severity in patients with acute- on- chronic hepatitis B liver failure( HBV- ACLF). Methods A total of 31 patients with HBV- ACLF who visited Fuzhou Infectious Disease Hospital from October 2013 to January 2015 were enrolled as study subjects. Another 28 patients with acute hepatitis B( AHB) and 30 patients with chronic hepatitis B( CHB) were enrolled as controls. The Q- Plex was used to measure the peripheral blood concentrations of cytokines including IL- 1Ra,interleukin- 1β( IL- 1β),interleukin- 6( IL- 6),interleukin- 4,interleukin- 10,tumor necrosis factorα( TNFα),and interferonγ. Liver function and coagulation function were examined for each group,and the correlations of concentrations of serum cytokines including IL- 1Ra with Model for End- Stage Liver Disease( MELD) score and HBV DNA were analyzed. The Kruskal- Wallis H test was used for comparison of continuous data between multiple groups,and the Mann- Whitney U test was used for comparison between any two groups; the chi- square test was used for comparison of categorical data between groups. The Spearman rank correlation was used for correlation analysis. Results The IL- 1Ra level and IL- 1Ra / IL- 1β ratio showed significant differences between the three groups( all P < 0. 05),and the HBV- ACLF group had a significantly higher IL- 1Ra level than the CHB group and the AHB group [186. 46( 162. 68-512. 90) pg/ml vs 70. 47( 47. 07-92. 47) pg/ml,Z =6. 300,P <0. 001; 186. 46( 162. 68-512. 90) pg/ml vs 143. 69( 117. 75-208. 54) pg / ml,Z = 2. 505,P = 0. 012]. The HBV- ACLF group had a significantly lower IL- 1Ra / IL- 1β ratio than the AHB group[2. 92( 2. 20- 4. 74) vs 4. 54( 2. 75- 6. 05),Z = 1. 966,P = 0. 048],but a significantly higher IL- 1Ra/IL- 1β ratio than the CHB group [2. 92( 2. 20- 4. 74) vs 2. 49( 1. 50- 2. 50),Z = 2. 682,P < 0. 001]. The HBV- ACLF group had significantly higher IL- 1β,IL- 6,and TNFα levels than the other two groups( all P < 0. 01). Serum IL- 1Ra level was negatively correlated with total bilirubin( TBil) and MELD score( r =- 0. 506 and- 0. 818,both P < 0. 01) but was positively correlated with prothrombin activity( PTA)( r =0. 475,P = 0. 007). Conclusion IL- 1Ra is negatively correlated with TBil and MELD score and positively correlated with PTA,which are the indicators for the severity of HBV- ACLF. IL- 1Ra may play an important role in the pathogenesis of HBV- ACLF.