Z Gastroenterol 2023; 61(01): e20
DOI: 10.1055/s-0042-1759956
Abstracts | GASL
Poster Visit Session ll Clinical Hepatology, Surgery, LTX 27/01/2023, 14.35 pm – 15.10 pm

Influence of NOD2 risk variants on the prevalence of hepatic encephalopathy and association with inflammation, bacterial translocation and immune activation in cirrhosis

Authors

  • Cristina Ripoll

    1   Internal Medicine IV. Jena University Hospital. Friedrich Schiller University, Jena

  • Robin Greinert

    2   Internal Medicine I. Martin Luther University Halle-Wittenberg, Halle

  • Philipp Reuken

    1   Internal Medicine IV. Jena University Hospital. Friedrich Schiller University, Jena

  • Matthias Christian Reichert

    3   Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg

  • Yvonne Hupfer

    1   Internal Medicine IV. Jena University Hospital. Friedrich Schiller University, Jena

  • Rafaela Staltner

    4   Dept. Ernährungswissenschaften, Universität Wien, Vienna, Austria

  • Frank Lammert

    3   Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg
    5   Hannover Health Science Campus, Hannover Medical School (MHH), Hannover

  • Tony Bruns

    6   Department of Medicine III, Aachen University Hospital, Aachen

  • Alexander Zipprich

    1   Internal Medicine IV. Jena University Hospital. Friedrich Schiller University, Jena
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Background and Aims NOD2 risk variants are associated increased bacterial translocation (BT). The aim of the study was to evaluate the association between the presence of NOD2 risk variants, BT, inflammation, and HE (covert and overt).

Patients and Methods This prospective multicenter study included patients with cirrhosis with genetic testing for the NOD2 risk variants and evaluated for covert (C) and overt (O) HE (CFF and clinical). Markers of systemic inflammation (leukocytes, CRP, IL-6, LBP) and immune activation (soluble CD14) as well as bacterial endotoxin (hTRL4 activation) were determined in serum.

Results Hundred seventy-two patients [70% men; median age 60 (IQR 54-66); MELD 12 (IQR 9-16); 72% ascites] were included, and 53 (31%) carried a NOD2 risk variant, 11% had OHE and 27% CHE. Presence and severity of HE and surrogates of inflammation, BT and immune activation are shown on table 1 (See table 1). The results did not change after adjustment for MELD. In contrast, HE (both OHE and CHE) was associated with increased systemic inflammation: CRP [w/o HE: 7.2 (2.7-16.7); with HE 12.6 (4.5-29.7) p<0.001] and soluble CD14 [w/o HE 2592 (2275 -3033); with HE 2755 (2410-3456), p=0.025].

Conclusions The presence of NOD2 risk variants in patients with cirrhosis is not associated with the presence of overt and covert HE and has no marked impact on inflammation, bacterial translocation or immune activation. In contrast, the presence of HE was linked to the acute phase response and myeloid


Publication History

Article published online:
18 January 2023

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