Balance between macrophage migration inhibitory factor and sCD74 predicts outcome in patients with acute decompensation of cirrhosis

Background & Aims Macrophage migration inhibitory factor (MIF) is an inflammatory cytokine and an important regulator of innate immune responses. We hypothesised that serum concentrations of MIF are associated with disease severity and outcome in patients with decompensated cirrhosis and acute-on-chronic liver failure (ACLF). Methods Circulating concentrations of MIF and its soluble receptor CD74 (sCD74) were determined in sera from 292 patients with acute decompensation of cirrhosis defined as new onset or worsening of ascites requiring hospitalisation. Of those, 78 (27%) had ACLF. Short-term mortality was assessed 90 days after inclusion. Results Although serum concentrations of MIF and sCD74 did not correlate with liver function parameters or ACLF, higher MIF (optimum cut-off >2.3 ng/ml) and lower concentrations of sCD74 (optimum cut-off
Graphical abstract
Highlights • MIF serum concentrations do not correlate with hepatic function but with systemic inflammation in decompensated cirrhosis patients. • MIF serum concentrations are independent of genetic MIF promoter polymorphisms in patients with decompensated cirrhosis. • MIF and sCD74 serum concentrations predict transplant-free 90-day survival in patients with decompensated cirrhosis. • Patients with decompensated cirrhosis and both high MIF and low sCD74 serum concentrations have impaired survival. • Patients with decompensated cirrhosis show a transhepatic gradient with higher MIF concentrations in right atrial blood.