Z Gastroenterol 2016; 54 - KV261
DOI: 10.1055/s-0036-1587037

Ascites neutrophil function is significantly impaired in patients with decompensated cirrhosis but can be restored by autologous plasma incubation

C Engelmann 1, C Becker 1, 2, A Boldt 2, T Herta 1, A Boehlig 1, K Splith 3, M Schmelzle 3, N Müller 1, S Krohn 1, HM Tautenhahn 4, M Bartels 4, U Sack 2, T Berg 1
  • 1Universitätsklinik Leipzig, Sektion Hepatologie, Leipzig, Deutschland
  • 2Universitätsklinik Leipzig, Abteilung für Klinische Immunologie, Leipzig, Deutschland
  • 3Charité – Universitätsmedizin Berlin, Department for General, Visceral and Transplantion Surgery, Berlin, Deutschland
  • 4Universitätsklinik Leipzig, Department für Allgemein-, Visceral- und Transplantationschirurgie, Leipzig, Deutschland

Background: Systemic immune cell dysfunction represents a typical feature of end-stage liver disease and increases the risk of bacterial infection, especially spontaneous bacterial peritonitis. To determine whether site-specific differences in host defense mechanisms exist and whether they contribute to sites of infection predilection we evaluated functional properties of neutrophil granulocytes in blood and ascites of patients with and without decompensated cirrhosis.

Material and methods: Between August 2014 and May 2015 blood and ascites samples were collected from 63 patients with cirrhosis and eight patients without cirrhosis. Neutrophil granulocytes were identified by flow cytometry and antibody staining. Phagocytosis and oxidative burst of both blood and ascites neutrophils were evaluated after in vitro stimulation with E. coli and fluorescence signals were measured by flow cytometry. Ascites neutrophil function tests were repeated after incubation with autologous plasma.

Results: Compared to their blood counterparts, ascites neutrophils showed a significantly impaired and more variable phagocytic rate and oxidative burst rate (median blood phagocytosis 98.1% (86.8 – 99.8) vs. median ascites phagocytosis 50.5% (0.4 – 97.3), p < 0.0001; median blood oxidative burst 98.7% (27.5 – 100) vs. median ascites oxidative burst 27.5% (0.3 – 96.7), p < 0.0001). Patients with non-cirrhotic ascites showed higher phagocytic activity but equally suppressed oxidative burst activity compared to patients with cirrhosis. Ascites neutrophil function could be partially restored after incubation with autologous plasma (median increase of phagocytosis: 22.5% (-49.7 – 93.2), p = 0.002; median increase of oxidative burst 22.8% (-10.4 – 48.8), p = 0.002).

Conclusions: Ascites neutrophils from patients with cirrhosis are functionally impaired, but can be partially restored after incubation with autologous plasma. Further investigations are needed to specify environmental factors in ascites that are associated with neutrophil function.