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| Purpose: Hepatitis B virus re-infection is a difficult problem to manage after liver transplantation (LT) in patients with cirrhosis. Whether performing a splenectomy at the time of LT would be beneficial or not remains controversial. This study was designed to investigate the functional changes of splenic macrophages in cirrhotic patients with hypersplenism in order to provide additional evidences by which to assess the value of splenectomy. Methods: Fourteen cirrhotic patients with hypersplenism and six controls were enrolled in the study. Serum lipopolysaccharide (LPS) was detected with a limulus assay. The differential expression of cytokines by splenic tissue and splenic macrophages between the cirrhosis and control groups was compared with cytokine arrays. Furthermore, splenic macrophages were cultured and stimulated with LPS, after which tumor necrosis factor (TNF)-α and interleukin (IL)-12 levels in the supernatant were determined. Results: In cirrhotic patients, serum LPS levels increased significantly. Interferon (IFN)-γ, TNF-β, and transforming growth factor (TGF)-β upregulated, whereas IL-4 and IL-5 levels didn’t change in splenic tissue. TNF-α upregulated significantly, while IL-4 and IL-5 levels had no significant changes in splenic macrophages. The IL-12 levels in culture media of splenic macrophages from cirrhotic patients were significantly lower than in controls after LPS stimulation. Conclusion: Endotoxemia and predominant Th1 inflammation in splenic tissue caused splenic macrophage M1 activation in cirrhotic patients with hypersplenism, but the immune functions of splenic macrophages were impaired. |
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| Keywords:巨噬细胞；脾切除；肝硬化；脾功能亢进；乙肝复发 |
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