Digestive Diseases and Sciences

, Volume 46, Issue 11, pp 2360–2366

Tumor Necrosis Factor-α, Interleukin-6, and Nitric Oxide in Sterile Ascitic Fluid and Serum from Patients with Cirrhosis Who Subsequently Develop Ascitic Fluid Infection

  • José Such
  • Donald J. Hillebrand
  • Carlos Guarner
  • Lee Berk
  • Pedro Zapater
  • Jim Westengard
  • Carmen Peralta
  • Germán Soriano
  • James Pappas
  • Bruce A. Runyon


Ascitic fluid infection probably results from repeated episodes of bacteremia and seeding of ascitic fluid. The outcome of these episodes of colonization is probably a function of serum and ascitic fluid defense mechanisms and the virulence of the organism. Patients who develop spontaneous bacterial peritonitis may have serum and ascitic fluid characteristics that are different from those who do not develop infection. We prospectively collected serum and ascitic fluid specimens at the time of admission from patients with sterile cirrhotic ascites, and tested these specimens for interleukin-6, tumor necrosis factor-α, and nitric oxide and compared these results as well as other characteristics of patients who did not develop infection to those who did. An elevated baseline serum tumor necrosis factor-α as well as an increased proportion of polymorphonuclear leukocytes in sterile ascitic fluid from patients who subsequently developed infection probably represent a subclinical activation of defense mechanisms from prior silent colonizations with bacteria.

spontaneous bacterial peritonitis ascitic fluid cirrhosis cytokine tumor necrosis factor-α interleukin-6 nitric oxide 


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Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • José Such
    • 1
  • Donald J. Hillebrand
    • 2
  • Carlos Guarner
    • 3
  • Lee Berk
    • 2
  • Pedro Zapater
    • 1
  • Jim Westengard
    • 2
  • Carmen Peralta
    • 3
  • Germán Soriano
    • 3
  • James Pappas
    • 2
  • Bruce A. Runyon
    • 2
    • 4
  1. 1.Liver UnitHospital General UniversitarioAlicanteSpain
  2. 2.Transplantation Institute, Center for Neuroimmunology and Department of Clinical PathologyLoma Linda University Medical CenterLoma LindaUSA
  3. 3.Liver UnitHospital de la Sta. Creu i St. PauBarcelonaSpain
  4. 4.Liver UnitRancho Los Amigos/University of Southern CaliforniaDowneyUSA

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