@article{oai:niigata-u.repo.nii.ac.jp:00006240,
 author = {HIDA, Seiji and HIRASAWA, Hiroyuki and ODA, Shigeto and MATSUDA, Kenichi and ENDOH, Hiroshi},
 issue = {4},
 journal = {Acta medica et biologica, Acta medica et biologica},
 month = {Dec},
 note = {Proinflammatory cytokines are thought to play important roles in the pathophysiology of encephalopathy in patients with fulminant hepatitis (FH). The aim of this study was to investigate the association between circulating proinflammatory cytokines and the severity of encephalopathy in FH patients. The study included 19 patients with FH who were treated in an intensive care unit (ICU) at Chiba University Hospital over the past 7 years. The patients were divided into three groups according to changing patterns of grades of hepatic encephalopathy during their ICU stay : those showing no deterioration of encephalopathy (ND group, n=6), those experiencing recovery and deterioration of encephalopathy (RD group, n=7), and those exhibiting progressive deterioration of encephalopathy (PD group, n = 6). Concentrations of circulating IL-1β, TNF-α, and IL-6, and ammonia were daily measured in the 3 groups. In serial measurements during the 1st week of ICU stay, serum concentrations of IL-6 were at significantly higher levels in PD group as compared with other two groups (both p<0.01) from the 5th ICU day to the 7th ICU day. In the RD group, serum concentrations of TNF-α and IL-6 were significantly higher during the period of redevelopment of encephalopathy as compared with the recovery period (both p<0.05). There was a significant relationship between serum TNF-α and IL-6 concentration as well as intracranial pressure (r=0.290, p<0.01 and r=0.516, p<0.01, respectively). In conclusion, TNF-α and IL-6, but not IL-1β, are implicated in the development of FH-related encephalopathy presumably by inducing intracranial hypertension.},
 pages = {141--148},
 title = {Proinflammatory Cytokines Correlate with the Development of Encephalopathy in Patients with Fulminant Hepatitis},
 volume = {52},
 year = {2004}
}