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Immunological Investigations Feb 2018Hepatocellular carcinoma (HCC) is the 3rd most common cause of cancer-related death worldwide. It has evolved different immune escape mechanisms, which might include...
BACKGROUND
Hepatocellular carcinoma (HCC) is the 3rd most common cause of cancer-related death worldwide. It has evolved different immune escape mechanisms, which might include emergence of lymphoid and myeloid regulatory cells. Aim of this work: To determine the numbers of Myeloid-derived suppressor cells (MDSCs) in peripheral blood and ascitic fluid in cirrhosis and HCC and their relation to IFN-γ and α-fetoprotein (α-FP).
PATIENTS AND METHODS
Sixty individuals were enrolled in this study; forty cirrhotic patients with ascites; twenty without HCC (Group I), and twenty with HCC (group II) as well as twenty healthy individuals as a control group (group III). The phenotype and numbers of MDSCs were analyzed in peripheral blood of all the individuals and ascitic fluid of the patients using flow cytometry. Intracellular IFN-γ and serum alfa-fetoprotein were measured.
RESULTS
Significant increases in the relative and the mean number of peripheral blood MDSCs were found in the cirrhosis and HCC groups than in the control group, with the HCC group showing the highest number. MDSC count was negatively correlated with IFN-γ levels, while α-FP was positively correlated with MDSC% in the HCC group. MDSC count was low in ascitic fluid of both HCC and cirrhosis groups with no significant difference between the 2 groups.
CONCLUSION
A high frequency of MDSCs was detected in the peripheral blood of cirrhotic and HCC patients, indicating presence of immunosuppressive arms. These cells could be targeted to develop a new effective immunotherapy or an adjuvant to current therapies.
Topics: Adult; Aged; Ascitic Fluid; Blood Cells; Blood Circulation; Carcinogenesis; Carcinoma, Hepatocellular; Cells, Cultured; Female; Fibrosis; Humans; Interferon-gamma; Liver Neoplasms; Male; Middle Aged; Myeloid-Derived Suppressor Cells; Tumor Escape; alpha-Fetoproteins
PubMed: 29182438
DOI: 10.1080/08820139.2017.1407787 -
Internal Medicine (Tokyo, Japan) Jul 2022Chylous ascites (CA) is the accumulation of fluid with a high triglyceride content in the peritoneal cavity. Only two cases in the literature have reported CA with...
Chylous ascites (CA) is the accumulation of fluid with a high triglyceride content in the peritoneal cavity. Only two cases in the literature have reported CA with hyperthyroidism. A 28-year-old previously healthy woman presented with gradual-onset abdominal swelling, exertional dyspnea, and diarrhea. Hyperthyroidism and heart failure were diagnosed using laboratory investigation and echocardiography. Ultrasonography revealed a large amount of ascites. The ascitic fluid was milky with elevated triglyceride levels. Treatment with anti-thyroid therapy and diuretics improved all symptoms, and the free triiodothyronine (T3) level normalized after five days. Hyperthyroidism and heart failure should be considered as reversible causes of CA.
Topics: Adult; Ascitic Fluid; Chylous Ascites; Female; Heart Failure; Humans; Hyperthyroidism; Triglycerides
PubMed: 34897150
DOI: 10.2169/internalmedicine.7873-21 -
Journal of Veterinary Emergency and... Jan 2021To estimate the frequency and amount of free peritoneal fluid in juvenile and adult dogs using the abdominal focused assessment with sonography for trauma (AFAST)...
OBJECTIVE
To estimate the frequency and amount of free peritoneal fluid in juvenile and adult dogs using the abdominal focused assessment with sonography for trauma (AFAST) abdominal fluid scoring system.
DESIGN
Prospective case series.
ANIMALS
Healthy, privately owned juvenile and adult dogs.
PROCEDURES
Dogs undergoing routine surgical sterilization were evaluated at induction with AFAST and assigned measurements and fluid scores. A surgeon scored the degree of peritoneal fluid found during ovariohysterectomy.
RESULTS
Ninety-two dogs were enrolled (46 juveniles and 46 adults). Ninety-three percent and 52% were AFAST positive for peritoneal fluid, respectively. The AFAST-positive view frequency for right lateral recumbency in juveniles was diaphragmatico-hepatic (DH) 100%, spleno-renal (SR) 20%, cysto-colic (CC) 40%, and hepato-renal (HR) 20% versus adults, DH 60%, SR 20%, CC 0%, and HR 0%, respectively. The AFAST-positive view frequency for left lateral recumbency was DH 93%, SR 44%, CC 24%, and HR 12% in juveniles, and DH 50%, SR 3%, CC 3%, and HR 10% in adults. Overall abdominal fluid scores (AFS) in juvenilles were 0 (n = 3), 1 (n = 14), 2 (n = 22), 3 (n = 6), and 4 (n = 1); and in adults, scores were 0 (n = 22), 1 (n = 18), 2 (n = 6), and 3 and 4 (n = 0). The AFS differed between adults and juveniles (P < 0.001). Most dogs had maximum fluid dimensions ≤3 × 3 mm and width of fluid stripes ≤3 mm. The AFS was positively correlated to fluid amount observed during ovariohysterectomy with fair agreement (kappa = 0.233, P = 0.012).
CONCLUSIONS AND CLINICAL RELEVANCE
This study establishes the frequency and amount of free peritoneal fluid in healthy juvenile and adult dogs during AFAST. Maximum fluid pocket dimensions of ≤3 × 3 mm and fluid stripe widths of ≤3 mm in dogs with AFS 1 and 2 may be normal. The DH view was most frequently positive.
Topics: Animals; Ascitic Fluid; Dogs; Female; Focused Assessment with Sonography for Trauma; Male; Prospective Studies; Reference Values
PubMed: 33175457
DOI: 10.1111/vec.13029 -
Iranian Journal of Immunology : IJI Jun 2019Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the...
BACKGROUND
Endometriosis is a chronic inflammatory disease with the growth of endometrial cells out of uterus and in the peritoneal cavity. T cell subsets participate in the establishment and progress of the disease by producing different cytokines.
OBJECTIVE
To investigate a group of cytokines related to Th1/Th2/Th17/Treg subsets within both peripheral blood and peritoneal fluid (PF) samples from infertile endometriosis women.
METHODS
Peripheral blood and PF samples were collected from 30 infertile endometriosis and 30 non-endometriosis fertile women during laparoscopy. Concentration of cytokines, including TNF-α, IFN-γ, TGF-β1, IL-4, IL-10, IL-17 and IL-23 were evaluated using ELISA method.
RESULTS
Results indicated that the concentration of IFN-γ within serum was significantly reduced in endometriosis group (p=0.001). Regarding PF cytokines, TGF-β1 was increased in endometriosis group (p=0.030). Furthermore, the ratios of IFN-γ/TGF-β1 and IL-17/IL-23 were significantly different between endometriosis and non-endometriosis women in serum samples (p<0.001 and p<0.01 respectively). The ratios of TNF-α/IL-10 and IL-17/IL-10 were also significantly different regarding PF samples between the two studied groups (p<0.04 and p<0.03 respectively). Finally, significant correlations were observed between the levels of IL-17 and IL-23, inflammatory and anti-inflammatory cytokines, in both samples and serum to PF inflammatory cytokines.
CONCLUSION
Based on the results of the present study, in women with endometriosis, the disturbance of cytokines network might gradually activate the inflammatory responses and tissue repair, resulting in endometriosis development after several years.
Topics: Adult; Ascitic Fluid; Cytokines; Endometriosis; Endometrium; Female; Humans; Infertility, Female; Middle Aged; T-Lymphocyte Subsets; Young Adult
PubMed: 31182689
DOI: 10.22034/IJI.2019.80258 -
Journal of Veterinary Internal Medicine Jan 2017Ascitic fluids of horses and humans have fibrinolytic activity, independent of the underlying mechanism of fluid formation.
BACKGROUND
Ascitic fluids of horses and humans have fibrinolytic activity, independent of the underlying mechanism of fluid formation.
OBJECTIVE
To determine whether coagulation and fibrinogenolytic/fibrinolytic activity (ie, low fibrinogen and increased fibrin-fibrinogen degradation products [FDPs], D-dimer, or both) occur in all types of ascitic fluid in dogs.
ANIMALS
A total of 70 client-owned dogs with ascites.
METHODS
In this cross-sectional study, dogs were categorized based on the pathophysiology of fluid formation into 4 groups: transudates due to decreased osmotic pressure, transudates due to increased hydrostatic pressure, exudates, and hemorrhagic ascites. Fibrinogen, FDPs, and D-dimer concentrations were measured and then compared in both ascitic fluid and plasma.
RESULTS
Ten dogs had transudates due to decreased colloid osmotic pressure, 18 had transudates due to increased hydrostatic pressure, 13 had exudates, and 29 had hemorrhagic ascites. Ascitic fibrinogen concentrations (n = 70) were significantly lower (median = 59 mg/dL; range: 59-122 mg/dL) than those in the plasma (median = 168 mg/dL, range: 59-879 mg/dL; P < .0001). Ascitic FDPs concentrations (n = 70) were significantly higher (<5 μg/mL: 3/70 dogs, ≥5 to <20 μg/mL: 11/70 dogs, ≥20 μg/mL: 56/70 dogs) than those in the plasma (<5 μg/mL: 17/70 dogs, ≥5 to <20 μg/mL: 28/70 dogs, ≥20 μg/mL: 25/70 dogs; P < .0001). Ascitic D-dimer concentrations (n = 70) were significantly higher (median = 3.98 μg/mL, range: 0.02-9.19) than those in the plasma (median = 0.11 μg/mL, range: 0.01-4.08; P < .0001). Analysis of the data for each of the 4 different types of ascites showed similar results to those of all the data analyzed together.
CONCLUSIONS AND CLINICAL IMPORTANCE
Ascitic fluid of dogs has evidence of coagulation activation and fibrinogenolytic/fibrinolytic activity and that this phenomenon occurs independent of the underlying mechanism that leads to the formation of ascites.
Topics: Animals; Ascites; Ascitic Fluid; Blood Coagulation Disorders; Cross-Sectional Studies; Dog Diseases; Dogs; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Male; Partial Thromboplastin Time
PubMed: 27862300
DOI: 10.1111/jvim.14610 -
Clinics and Research in Hepatology and... May 2021Abdominal paracentesis is performed as a diagnostic test in children with ascites. Serum albumin to ascitic fluid albumin gradient (SAAG) is frequently used in adults to...
BACKGROUND
Abdominal paracentesis is performed as a diagnostic test in children with ascites. Serum albumin to ascitic fluid albumin gradient (SAAG) is frequently used in adults to distinguish types of portal hypertension. We aim to investigate the utilization of SAAG and other biomarkers in determining the etiology of significant ascites in children.
METHODS
In this retrospective study, children aged 0-21 years with significant ascites were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and medical records during the period 1983-2010. Medical records of children who had abdominal paracentesis were examined in detail.
RESULTS
207 children had significant ascites and of those children, 20 (9.6%) had abdominal paracentesis. Our data showed that high albumin gradient (SAAG ≥ 1.1 g/dL) differentiates causes of ascites secondary to portal hypertension (cirrhosis, hepatic vein outflow obstruction, or congestive hepatopathy) from other causes. In addition, ascitic fluid total protein (AFTP) may help in differential diagnosis of ascites. Children with high SAAG manifest clinical features of portal hypertension including esophageal varices or variceal hemorrhage.
CONCLUSION
Among patients with initially unclear causes of ascites, SAAG and AFTP can provide guidance for appropriate investigations.
Topics: Adult; Ascites; Ascitic Fluid; Child; Diagnostic Tests, Routine; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Liver Cirrhosis; Retrospective Studies; Serum Albumin
PubMed: 33268292
DOI: 10.1016/j.clinre.2020.09.010 -
Anticancer Research Feb 2024Malignant ascites is a common condition in patients with terminal cancer. Treatments, such as diuretics, percutaneous drainage of ascites, and abdominal vein shunting... (Observational Study)
Observational Study
BACKGROUND/AIM
Malignant ascites is a common condition in patients with terminal cancer. Treatments, such as diuretics, percutaneous drainage of ascites, and abdominal vein shunting have been advocated. However, these treatments have not achieved sufficient palliative effects. Therefore, the development of innovative therapies is mandated, especially for new therapies that require the creation of a fluid simulation of malignant ascites. However, there have been no previous studies on the physical properties of malignant ascites, including viscosity, which are necessary for the development of such a fluid. Therefore, we prospectively investigated the physical properties of malignant ascites.
PATIENTS AND METHODS
This single-center, prospective, observational study included 30 patients between November 2021 and January 2023. The primary endpoint was the viscosity of the malignant ascites, and the secondary endpoints included other viscosity studies, biochemical tests, and the presence of malignant cells in the ascites.
RESULTS
The median viscosity was 1.105 mPa*S. The viscosity of malignant ascites tended to decrease with increasing temperature, which is common for liquids. Malignant ascites fluid containing malignant cells tended to be more viscous than ascites fluid without malignant cells; furthermore, albumin levels tended to be higher in the former than in the latter.
CONCLUSION
Malignant ascites' median viscosity was 1.105 mPa*S. Correlation between viscosity and temperature showed a decreasing trend. These findings contribute valuable insights for future malignant ascites management and device development.
Topics: Humans; Ascites; Prospective Studies; Viscosity; Ascitic Fluid; Peritoneal Neoplasms
PubMed: 38307583
DOI: 10.21873/anticanres.16841 -
Bangladesh Medical Research Council... Dec 2014This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA...
This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69 ± 21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with 'histopathological diagnosis' was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.
Topics: Adenosine Deaminase; Adolescent; Adult; Ascitic Fluid; CA-125 Antigen; Cross-Sectional Studies; Diagnosis, Differential; Humans; Interviews as Topic; Middle Aged; Peritonitis, Tuberculous; Qualitative Research; Sensitivity and Specificity; Young Adult
PubMed: 26402971
DOI: 10.3329/bmrcb.v40i3.25228 -
Scandinavian Journal of Gastroenterology Jan 2018Patients with liver cirrhosis and ascites have a poor prognosis with increased risk of infection related death, as advanced stages of cirrhosis are associated with... (Observational Study)
Observational Study
BACKGROUND AND AIM
Patients with liver cirrhosis and ascites have a poor prognosis with increased risk of infection related death, as advanced stages of cirrhosis are associated with immunodeficiency. We aimed to investigate immunologically active molecules in ascitic fluid and blood and their potential association to survival.
MATERIALS AND METHODS
In an exploratory pilot study; blood and ascitic fluid from 34 patients with liver cirrhosis of different etiology were analyzed for pattern recognition molecules (ficolin-1, ficolin-2, ficolin-3 and MBL) and complement proteins (C4 and C3). An observational follow-up study (minimum 17 months) was conducted to assess the association to all-cause mortality or liver transplantation.
RESULTS
Ficolin-1, ficolin-2, MBL, C4 and C3 in ascitic fluid and ficolin-1, C4 and C3 in blood were significantly (p = .001-.027) lower in patients with Child-Pugh stage C (n = 16, 47%) compared to Child-Pugh stage B cirrhosis (n = 18, 53%). In multivariate COX-regression analysis low levels of ficolin-1(p = .036) and C3 (p = .025) in ascitic fluid and C4(p = .005) and C3 (p = .032) in serum were associated with all-cause mortality or liver transplantation independent of Child-Pugh score.
CONCLUSION
Levels of lectin-complement pathway molecules in ascitic fluid and blood are lower in patients with more advanced stage of cirrhosis. Low C4 and C3 in serum and C3 and ficolin-1 in ascitic fluid are risk factors for all-cause mortality or liver transplantation independently of liver function in patients with cirrhosis and ascites.
Topics: Adult; Aged; Ascites; Ascitic Fluid; Complement System Proteins; Denmark; Female; Follow-Up Studies; Humans; Lectins; Liver Cirrhosis; Liver Transplantation; Male; Middle Aged; Multivariate Analysis; Pilot Projects; Prognosis; Proportional Hazards Models; Severity of Illness Index
PubMed: 28982257
DOI: 10.1080/00365521.2017.1386710 -
Indian Journal of Gastroenterology :... Aug 2020There is scarce data from the Indian subcontinent on the outcomes following spontaneous bacterial peritonitis (SBP). (Observational Study)
Observational Study
BACKGROUND
There is scarce data from the Indian subcontinent on the outcomes following spontaneous bacterial peritonitis (SBP).
AIM
To study the immediate (within 30 days) and short-term mortality (31-90 days) associated with SBP and to determine the predictors of the same.
METHODS
This prospective observational study was done among patients with liver cirrhosis who underwent paracentesis. Patient data included age, gender, co-morbidity, cirrhosis-related complications, model of end-stage liver disease (MELD), and Child-Turcotte-Pugh (CTP) scores. SBP was diagnosed based on ascitic fluid polymorphonuclear leukocyte count > 250/mm with or without ascitic fluid culture positivity.
RESULTS
Of the 870 patients with cirrhosis and ascites registered during the study period, 610 fulfilled the criteria for inclusion. Altogether, 122 patients with SBP were identified: 52 (42.6%) died, 40 (32.8%) survived without liver transplant, and 30 (24.6%) underwent liver transplantation within 3 months. Thirty-two patients (26.2%) were blood culture posi tive for bacteria and 7 (5.7%) demonstrable bacterial growth in ascitic fluid. Blood culture positivity was significantly higher in the group with immediate mortality (p < 0.0001) and was also significantly associated (p 0.005) with mortality at 3 months.
CONCLUSION
Nearly two-fifths (42.6%) of the study cohort died within 3 months of an episode of SBP. Four-fifths of these patients died within 30 days. Blood culture positivity was significantly associated with immediate and short-term mortality.
Topics: Adult; Aged; Ascitic Fluid; Bacterial Infections; Blood Culture; Cohort Studies; Female; Humans; Leukocyte Count; Male; Middle Aged; Neutrophils; Peritonitis; Predictive Value of Tests; Prospective Studies; Time Factors
PubMed: 32770323
DOI: 10.1007/s12664-020-01040-z