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  • Meeting abstract
  • Open Access

Association between interleukin-10 (IL-10) gene promoter polymorphisms and outcome in acetaminophen induced acute liver failure requiring admission to a liver intensive care unit

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care20003 (Suppl 1) :P183

https://doi.org/10.1186/cc556

  • Published:

Keywords

  • Acetaminophen
  • Acute Liver Failure
  • Multiorgan Failure
  • Acetaminophen Overdose
  • Gene Promoter Polymorphism

Background

The outcome of severe hepatic necrosis following acetaminophen overdose is unpredictable and may have up to a 90% mortality. IL-10 is an anti-inflammatory cytokine which plays a pivotal role in inflammation and potentially in multiorgan failure. Elevated plasma levels of IL-10 are found in patients with acute liver failure. Polymorphisms in the promoter region of the IL-10 gene have recently been described comprising three single base-pair substitutions at positions (-1082, -819, -592) resulting in three common three haplotypes GCC, ACC and ATA. The GCC/GCC genotype is associated with higher IL-10 production, and ATA haplotype with lower production.

Patients and methods

96 patients with severe acetaminophen hepatotoxicity requiring intensive care were studied. IL-10 gene polymorphisms were determined by sequence-specific oligonucleotide probing using a standard PCR based technique. Haplotype frequencies were compared with those of 71 racially and geographically matched controls.

Results

See Table.

Conclusion

There is no significant association between outcome or incidence of multiorgan failure in patients with acetaminophen induced acute liver failure and these three common IL-10 gene promoter haplotypes.

Table

Patients (no)

No. haplotypes

GCC

ATA

ACC

Controls (71)

142

47%

25%

28%

All patients (96)

192

56%

19%

25%

Survivors (60)

120

57%

20%

23%

Non survivors/Tx (36)

72

54%

18%

28%

ARDS (25)

50

56%

20%

24%

ARF (47)

94

61%

18%

21%

Hypotensive/

64

56%

20%

24%

vasopressors (32)

    

ARF, acute renal failure: creatinine > 300 μ mol/l and/or oliguria requiring haemofiltration; ARDS, acute respiratory distress syndrome: PaO2 (kPa)/FiO2 <20, PEEP >5 cmH2O; Tx, liver transplant. Haplotype frequencies were compared using Χ2 test with Yates correction.

Authors’ Affiliations

(1)
Institute of Liver Studies, Kings College Hospital, Denmark Hill, London, TX, SE5 8RX, UK

Copyright

© Current Science Ltd 1999

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