El patrón de producción de citocinas proinflamatorias en el líquido ascítico de pacientes con cirrosis está relacionado con la etiología viral (VHC) o alcohólica

The histopathology of alcohol and HCV induced cirrhosis is very similar, nonetheless immune response- related gene expression profiles in liver show differences according to the disease s etiology. The aim of this study is to explore differences at molecular level analyzing the inflammatory profile of ascitic fluid and peritoneal monocyte-derived macrophages from both etiologies in cirrhotic patients. To do so, we studied 45 patients with cirrhosis and non-infected ascites, distributed according to disease etiology, HCV (n=15) or alcohol (n=30). Cytokines were assessed by ELISA in ascitic fluid and supernatants from peritoneal monocyte-derived macrophages isolated and stimulated in vitro with LPS, CpG oligodeoxynucleotides or Candida albicans yeast cells. Results showed that, whereas no differences in peripheral blood cell subpopulations could be achieved, cellular content in ascitic fluid were more abundant in HCV vs alcohol etiology. Higher levels of IL-10 and lower levels of IL-6 and IL-12 were present in ascitic fluid from HCV group. Cytokines levels referred to the number of M-DM f ascites also revealed lower TNF-α and IL-6 levels in patients of HCV etiology. Isolated peritoneal monocyte-derived macrophages kept their primed status in vitro for the extent of 24h culture in the presence or absence of stimulation. In conclusion, a different pattern of leukocyte migration from blood to peritoneal cavity in cirrhosis is observed depending on the viral or alcoholic etiology. Cirrhosis of HVC etiology is associated to decreased inflammatory profile in ascitic fluid compared with alcoholic etiology. These findings could contribute to indentifying potential prognostic or therapeutic targets for chronic liver diseases from different etiologies.