The plasma levels of interleukin (IL)-1α, IL-1β and IL-1 receptor antagonist (IL-1Ra) are increased in cirrhotic patients. We aimed to investigate whether these cytokines correlate with hepatic venous pressure gradient (HVPG), the severity of liver cirrhosis and complications of cirrhosis.

Sixty-three cirrhotic patients that underwent hemodynamic studies in Taipei Veterans General hospital were enrolled retrospectively. Plasma levels of IL-1α, IL-1β, IL-1Ra and endotoxin were assessed by enzyme-linked immunosorbent assay. Plasma obtained from 11 healthy subjects served as normal controls.

Plasma levels of IL-1α, IL-1β and IL-1Ra were increased in cirrhotic patients compared with controls (3.84 ± 2.17 pg/ml, 1.53 ± 1.56 pg/ml, 854.97 ± 396.29 pg/ml vs. 0, 0, 411.70 ± 100.32 pg/ml, respectively). IL-1Ra levels significantly correlated with plasma endotoxin levels (r=0.329, p=0.008), Child-Pugh scores (r=0.421, p=0.001), Model of end-stage liver disease (MELD) scores (r=0.343, p=0.006) and HVPG (r=0.385, p=0.002). On multivariate analysis, higher IL-1Ra levels (≥760 pg/ml) predicted the occurrence of portal hypertension related complications [hazard ratio (HR): 3.001; 95% confidence interval (CI): 1.484-6.071; p=0.002] and the development of bacterial infections (HR: 2.054; 95% CI: 1.081-3.903; p=0.028) independently of the MELD scores and portal pressure. Furthermore, higher IL-1Ra levels also predicted the survival in patients without hepatocellular carcinoma (HR: 15.143; 95% CI: 2.884-79.509; p=0.001).

The plasma IL-1Ra level correlates with HVPG. Additionally, it may predict the occurrence of portal hypertension related complications and bacterial infections in cirrhotic patients and the survival in patients without hepatocellular carcinoma.