Acute on Chronic Hepatic Failure, Liver Diseases
Conditions
Brief summary
The main objective of this study is the comparison of the profile of the pro-inflammatory cytokines at the patients suffering from an alcoholic hepatitis to that of two groups witnesses: patients suffering from an alcoholic cirrhosis and unhurt patients of chronic liver disease
Interventions
OTHERcollection of liver biopsies collection of blood samples
blood and ascites samples; extraction of explants, hepatic resection parts; hepatic parenchyma on liver biopsies
Sponsors
University Hospital, Lille
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* group A: patients with acute alcoholic hepatitis * Active alcohol abuse defined by DSM IV and excessive alcohol consumption prior to admission (\> 60 g per day for men and\> 40 g per day for women) * Moderate elevation of transaminases (less than 500 U / L) with a typical ASAT / ALAT ratio of 2: 1 * Bilirubin\> 50 mg / l * Absence of autoimmune liver disease (ANA \<1/80, AML \<1/80, LKM1 neg, AAM neg) * Absence of hepatitis B and C and HIV infection (negative anti-HIV antibodies, negative HBsAg, negative HCV PCR) * Patients with other acute complications than alcoholic hepatitis may be included (eg, digestive hemorrhage, acute renal failure, infection, etc.) * Because there is no validated noninvasive tool for the diagnosis of alcoholic hepatitis, histological confirmation is required in all patients (preferably by transjugular biopsy): alcoholic hepatitis will be diagnosed on the presence of the following histological characteristics: Hepatocellular lesions (ballooning, Mallory body)/ Inflammatory infiltrate with polymorphonuclear neutrophils * group B1: patients with alcoholic cirrhosis * Decompensated or non-decompensated alcoholic cirrhosis, defined according to the HAS guidelines, ie by a liver biopsy or a cluster of clinico-biological arguments (www.has-sante.fr) * group B2: patients free from chronic liver disease * Justification of blood and liver sampling for the management of a pathology other than chronic liver disease (eg liver metastasis of digestive cancer occurring on healthy liver)
Exclusion criteria
* For groups A and B1: * Patients with hepatocellular carcinoma of progressive non-hepatic cancer * Presence of HBsAg * Presence of anti-HCV antibodies by positive PCR * Presence of antibodies to HIV 1 +2 * Pregnancy * for group B2: * Alcoholic liver disease * Presence of HBsAg * Presence of anti-HCV antibodies by positive PCR * Presence of antibodies to HIV 1 +2 * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the expression of proinflammatory cytokines | Baseline | Proinflammatory Cytokines (TNF, IL-1, IL-6, IL-8) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| the expression of genetic variants of pro-inflammatory cytokines | Baseline | Identification of genetic variants of pro-inflammatory cytokines that contribute to mortality of Alcoholic Liver Disease |
| Cell lysis (AST, ALT, CK18 cleaved) | Baseline | — |
| Regeneration markers (Ki-67, Fn14, CK7) | Baseline | — |
Countries
France
Contacts
CONTACTPhilippe Mathurin, MD,PhD
PRINCIPAL_INVESTIGATORPhilppe Mathurin, MD,PhD
University Hospital, Lille
Outcome results
None listed