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Selective improvement by rifaximin of changes in the immunophenotype in patients who improve minimal hepatic encephalopathy

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Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Garcia-Garcia, R
  • Leone, P
  • Rios, MP
  • Durban, L
  • Aparicio, L
  • Felipo, V

Grupos y Plataformas de I+D+i

Abstract

Background Minimal hepatic encephalopathy (MHE) in cirrhotic patients is associated with specific changes in parameters of the immune system reflecting a more pro-inflammatory environment than in patients without MHE. The aims of this work were to assess the effects of rifaximin treatment of cirrhotic patients with MHE on: (1) MHE; (2) intermediate (CD14(++)CD16(+)) pro-inflammatory monocytes; (3) expression of early activation marker CD69 in T lymphocytes; (4) autoreactive CD4(+)CD28(-) T lymphocytes; (5) differentiation of CD4(+) T lymphocytes to Th follicular and Th22; (6) serum IgG levels; and (7) levels of some pro-inflammatory cytokines. Methods These parameters were measured by immunophenotyping and cytokine profile analysis in 30 controls without liver disease, 30 cirrhotic patients without MHE and 22 patients with MHE. Patients with MHE were treated with rifaximin and the same parameters were measured at 3 and 6 months of treatment. We assessed if changes in these parameters are different in patients who improve MHE (responders) and those who remain in MHE (non-responders). Results Rifaximin improved MHE in 59% of patients with MHE. In these responder patients rifaximin normalized all alterations in the immune system measured while in non-responders it normalizes only IL-6, CCL20, and differentiation of T lymphocytes to Th22. Non-responder patients do not show increased expression of CD69 before treatment. Conclusions Rifaximin normalizes changes in the immune system in patients who improve MHE but not in non-responders. Some alterations before treatment are different in responders and non-responders. Understanding these differences may identify predictors of the response of MHE to rifaximin.

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Datos de la publicación

ISSN/ISSNe:
1479-5876, 1479-5876

Journal of Translational Medicine  BIOMED CENTRAL LTD

Tipo:
Article
Páginas:
293-293
PubMed:
31462286

Citas Recibidas en Web of Science: 24

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Keywords

  • Minimal hepatic encephalopathy; Rifaximin; Immunophenotype; T lymphocytes activation

Financiación

INSTITUTO SALUD CARLOS III (PI15/00035)
INSTITUTO SALUD CARLOS III (PI18/00150)

Proyectos y Estudios Clínicos

Caracterización de las alteraciones neurológicas en pacientes con encefalopatía hepática mínima y de las alteraciones cerebrales responsables. Contribución del estrés oxidativo y la inflamación.

Investigador Principal: MARÍA DEL CARMEN MONTOLIU FÉLIX

PI15/00035 . INSTITUTO SALUD CARLOS III . 2016

Caracterización de las alteraciones neurológicas y cerebrales en pacientes con encefalopatía hepática mínima. Contribucu¡ión de la Inflamación. Implicaciones diagnósticas y terapéuticas

Investigador Principal: MARÍA DEL CARMEN MONTOLIU FÉLIX

PI18/00150 . INSTITUTO SALUD CARLOS III . 2019

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