Systemic inflammation and immune cell phenotypes are associated with neuro-psychiatric symptoms in patients with chronic inflammatory liver diseases

Liver Int. 2018 Dec;38(12):2317-2328. doi: 10.1111/liv.13869. Epub 2018 Jun 12.

Abstract

Background & aims: Chronic inflammatory liver diseases are frequently associated with neuropsychiatric and cognitive dysfunctions. We hypothesized that symptomatic patients may show altered levels of soluble inflammatory mediators (SIMs) as well as changes in immune cell phenotypes.

Methods: A comprehensive immune-phenotyping including investigation of 50 SIMs as well as ex-vivo phenotypes of NK-cells, CD3+, CD4+, CD8+ and regulatory T cells in 40 patients with viral and autoimmune chronic liver diseases was performed. The patients' cognitive functions were assessed using an extensive battery of neuropsychological testing.

Results and conclusion: Overall, our data indicate that while SIMs are significantly up-regulated, NK- and T-cells are less-activated in patients with neuropsychiatric symptoms accompanying chronic inflammatory liver diseases compared to patients without these symptoms. Moreover, HCV patients showed a unique pattern of immune alterations as compared to patients with HBV, autoimmune hepatitis and primary biliary cirrhosis. These findings hint towards potential mechanisms explaining these symptoms in patients with chronic liver diseases.

Keywords: AIH; HBV; HCV; Immune cell phenotypes; PBC; Soluble inflammatory mediators; fatigue; neuro-psychiatric symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibody Formation
  • Antigens, CD / analysis
  • Autoantibodies / analysis
  • Biomarkers / analysis*
  • Chronic Disease
  • Cognitive Dysfunction / complications*
  • Cognitive Dysfunction / immunology
  • Cross-Sectional Studies
  • Fatigue / physiopathology*
  • Female
  • Germany
  • Hepatitis, Chronic / immunology
  • Hepatitis, Chronic / physiopathology
  • Humans
  • Immunity, Cellular
  • Liver / pathology
  • Liver Cirrhosis, Biliary / immunology
  • Liver Cirrhosis, Biliary / physiopathology
  • Liver Diseases / complications
  • Liver Diseases / immunology*
  • Liver Diseases / physiopathology*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Phenotype
  • T-Lymphocytes / immunology

Substances

  • Antigens, CD
  • Autoantibodies
  • Biomarkers