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Anti-tumor necrosis factor-alpha monoclonal antibody therapy in severe alcoholic hepatitis
- Source :
-
Journal of Hepatology . Apr2003, Vol. 38 Issue 4, p419. 7p. - Publication Year :
- 2003
-
Abstract
- Background/Aims: Severe alcoholic hepatitis (AH) is associated with high mortality. Tumor necrosis factor-alpha (TNFα) has been demonstrated to play an important role in its pathophysiology.Methods: Twelve patients with biopsy-confirmed AH and a Maddrey discriminant factor >32 were treated with a single infusion of the anti-TNF monoclonal antibody Infliximab at a dose of 5 mg/kg body weight. Serial measurements were made for various cytokines using specific enzyme-linked immunoassays (ELISA). In four patients, liver biopsy samples were available pretreatment and on day+28 of therapy.Results: Ten of the 12 patients are alive at a median of 15 (12–20) months. Two patients died within 30 days from septicemia. Serum bilirubin levels, Maddrey score, neutrophil count and C-reactive protein fell significantly within the first month. There was an early, though not significant, decrease in plasma levels of proinflammatory cytokines (interleukins (IL)-1β, IL-6, IL-8, interferon-gamma), whereas plasma levels of TNFα remained near the sensitivity limit of the assay throughout the treatment course. While TNFα mRNA expression in the liver did not change, expression of IL-8, a cytokine regulated mainly by TNFα, was almost absent on day+28.Conclusions: Our data suggest that randomized controlled trials of anti-TNF antibody in severe AH are warranted. [Copyright &y& Elsevier]
- Subjects :
- *CYTOKINES
*TUMOR necrosis factors
Subjects
Details
- Language :
- English
- ISSN :
- 01688278
- Volume :
- 38
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Journal of Hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 9340158
- Full Text :
- https://doi.org/10.1016/S0168-8278(02)00442-7