Clinical and Experimental Gastroenterology (Jun 2021)

Diminished Non-Classical Monocytes in the Blood Associate with Disease Severity in Alcoholic Hepatitis

  • Rasmussen EB,
  • Eriksen LL,
  • Greisen SR,
  • Hansen AL,
  • Carstensen M,
  • Sandahl TD,
  • Støy S,
  • Kragstrup TW

Journal volume & issue
Vol. Volume 14
pp. 259 – 267

Abstract

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Elisabeth Busk Rasmussen,1 Lotte Lindgreen Eriksen,2 Stinne Ravn Greisen,1 Anne Louise Hansen,1 Mikkel Carstensen,1 Thomas Damgaard Sandahl,2 Sidsel Støy,2 Tue Wenzel Kragstrup1,3 1Department of Biomedicine, Aarhus University, Aarhus, Denmark; 2Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; 3Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, DenmarkCorrespondence: Tue Wenzel KragstrupDepartment of Biomedicine, Aarhus University, Wilhelm Meyers Allé 4, Aarhus C, DK-8000, DenmarkTel +4587167265Email [email protected]: Alcoholic hepatitis (AH) holds a high mortality, and vast macrophage infiltration of the liver is involved in the progressive liver injury. No efficient medical treatment exists, and macrophages may be a future treatment target. Here, we examine associations between non-classical monocyte subsets and cell surface markers of migration with disease activity in patients with severe AH.Methods: We analyzed samples from two cohorts of patients with AH. Cohort 1 included 15 AH patients, followed for 30 days, and 8 healthy controls (HCs). Cohort 2 included 23 AH patients, followed for 90 days, and 9 HCs. Peripheral blood mononuclear cells (PBMCs) from both cohorts were analyzed by flow cytometry. Liver biopsies from cohort 2 were analyzed by RNA sequencing.Results: Circulating non-classical monocytes in all but absent in patients with AH compared to HC in both cohorts (both p< 0.0001). The frequency of non-classical monocytes was significantly associated with Maddrey’s discriminant function (mDF) (r=− 0.79, p=0.0008, cohort 1), Child–Pugh score (CP) (r=− 0.56, p=0.03, cohort 1), Model for End-Stage Liver Disease (MELD) (r=− 0.54, p=0.02, cohort 2) and C-reactive protein (CRP) (r=− 0.51, p=0.027, cohort 2). The surface expression of CD11b was increased on non-classical monocytes in patients with AH compared to HC (p< 0.0001) (cohort 1). The mRNA expression of CD11b was increased in liver biopsies in patients with AH compared to HC (cohort 2) (p< 0.0001).Conclusion: In this study, we describe an almost complete depletion of circulating non-classical monocytes in the blood in two independent cohorts of patients with AH, which may be associated with a possible harmful recruitment of these cells to the liver. These results contribute to a better understanding of the disease, which hopefully can lead to therapies that target the acute inflammatory response leading to severe AH.Keywords: monocytes, non-classical, alcoholic hepatitis, CD11b, CCR2, CX3CR1

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