Association between serum tumor necrosis factor-α and sarcopenia in liver cirrhosis
한지원, 김다인, 남희철, 장우임, 양진모, 송도선,
소속 상세정보
한지원 ( Han Ji-Won )
Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
김다인 ( Kim Da-In )
Catholic University College of Medicine St. Vincent’s Hospital Department of Internal Medicine
남희철 ( Nam Hee-Chul )
Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
장우임 ( Chang U-Im )
Catholic University College of Medicine St. Vincent’s Hospital Department of Internal Medicine
양진모 ( Yang Jin-Mo )
Catholic University College of Medicine St. Vincent’s Hospital Department of Internal Medicine
송도선 ( Song Do-Seon )
Catholic University College of Medicine St. Vincent’s Hospital Department of Internal Medicine
Abstract
Background/Aims: Sarcopenia is an independent prognostic factor of liver cirrhosis (LC). However, the association between LC-related systemic inflammation and sarcopenia is unclear.
Methods: Sprague-Dawley rats were treated with thioacetamide (TAA) or saline as a control. Rifaximin was administered to TAA-induced LC rats. Enzyme-linked immunosorbent assay was performed to measure inflammatory mediators in rat serum. RT-PCR was performed to measure the molecular expression in tissues. Hematoxylin and eosin (H&E) staining and immunohistochemistry were performed to investigate tissue pathology. Serum tumor necrosis factor-α levels, liver stiffness (LS), and the L3 skeletal muscle index (L3SMI) were measured in 60 patients with chronic liver disease.
Results: LC and sarcopenia were successfully induced by TAA. Serum TNF-α levels were increased in LC rats and correlated with myostatin expression, muscle weight, and myofiber diameter. The expression of intestinal occludin and zona occludens-1 was reduced in LC rats and associated with serum TNF-α levels and sarcopenia. In patients with LS ≥7 kPa or sarcopenia, serum TNF-α levels were significantly increased, which was also confirmed when we raised the LS cutoff to 10 kPa. The L3SMI was inversely correlated with serum TNF-α levels in patients with LS ≥7 kPa. TNF-α was reduced by rifaximin, which might have resulted in reduced expression of muscular MuRF1 and myostatin and improvements in myofiber diameters within muscle tissues.
Conclusions: These results suggest that serum TNF-α is associated with LC-related sarcopenia. Rifaximin might be effective in reducing serum TNF-α levels and improving sarcopenia in LC, but these results need to be validated in future studies.
키워드
Sarcopenia; Liver cirrhosis; Tumor necrosis factor-alpha; Rifaximin
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