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

• Published in: Liver international 2018-12, Vol.38 (12), p.2317-2328
• Main Authors: Aregay, Amare, Dirks, Meike, Schlaphoff, Verena, Owusu Sekyere, Solomon, Haag, Kim, Falk, Christine Susanne, Hengst, Julia, Bremer, Birgit, Schuppner, Ramona, Manns, Michael P., Pflugrad, Henning, Cornberg, Markus, Wedemeyer, Heiner, Weissenborn, Karin
• Format: Article
• Language: English
• Subjects: Adult; AIH; Antibody Formation; Antigens, CD - analysis; Autoantibodies - analysis; Biomarkers - analysis; CD3 antigen; CD4 antigen; CD8 antigen; Chronic Disease; Cirrhosis; Cognitive ability; Cognitive Dysfunction - complications; Cognitive Dysfunction - immunology; Cross-Sectional Studies; Diseases; fatigue; Fatigue - physiopathology; Female; Germany; HBV; HCV; Hepatitis; Hepatitis, Chronic - immunology; Hepatitis, Chronic - physiopathology; Humans; Immune cell phenotypes; Immune system; Immunity, Cellular; Immunoregulation; Liver; Liver - pathology; Liver cirrhosis; Liver Cirrhosis, Biliary - immunology; Liver Cirrhosis, Biliary - physiopathology; Liver diseases; Liver Diseases - complications; Liver Diseases - immunology; Liver Diseases - physiopathology; Lymphocytes; Lymphocytes T; Male; Measuring techniques; Mental disorders; Middle Aged; Neuropsychological Tests; neuro‐psychiatric symptoms; Patients; PBC; Phenotype; Phenotypes; Phenotyping; Primary biliary cirrhosis; Psychology; Soluble inflammatory mediators; T-Lymphocytes - immunology
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.13869

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.