PMID- 27359339 OWN - NLM STAT- MEDLINE DCOM- 20170724 LR - 20230120 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 11 IP - 6 DP - 2016 TI - Urine Monocyte Chemoattractant Protein-1 Is an Independent Predictive Factor of Hospital Readmission and Survival in Cirrhosis. PG - e0157371 LID - 10.1371/journal.pone.0157371 [doi] LID - e0157371 AB - MCP-1 (monocyte chemoattractant protein-1) is a proinflammatory cytokine involved in chemotaxis of monocytes. In several diseases, such as acute coronary syndromes and heart failure, elevated MCP-1 levels have been associated with poor outcomes. Little is known about MCP-1 in cirrhosis. AIM: To investigate the relationship between MCP-1 and outcome in decompensated cirrhosis. METHODS: Prospective study of 218 patients discharged from hospital after an admission for complications of cirrhosis. Urine and plasma levels of MCP-1 and other urine proinflammatroy biomarkers: osteopontin(OPN), trefoil-factor3 and liver-fatty-acid-binding protein were measured at admission. Urine non-inflammatory mediators cystatin-C, beta2microglobulin and albumin were measured as control biomarkers. The relationship between these biomarkers and the 3-month hospital readmission, complications of cirrhosis, and mortality were assessed. RESULTS: 69 patients(32%) had at least one readmission during the 3-month period of follow-up and 30 patients died(14%). Urine MCP-1 and OPN levels, were associated with 3-month probability of readmission (0.85 (0.27-2.1) and 2003 (705-4586) ug/g creat vs 0.47 (0.2-1.1) and 1188 (512-2958) ug/g creat, in patients with and without readmission, respectively; p<0.05; median (IQR)). Furthermore, urine levels of MCP-1 were significantly associated with mortality (1.01 (1-3.6) vs 0.5 (0.2-1.1) mug/g creat, in dead and alive patients at 3 months; p<0.05). Patients with higher levels of urine MCP-1 (above percentile 75th) had higher probability of development of hepatic encephalopathy, bacterial infections or AKI. Urine MCP-1 was an independent predictive factor of hospital readmission and combined end-point of readmission or dead at 3 months. Plasma levels of MCP-1 did not correlated with outcomes. CONCLUSION: Urine, but not plasma, MCP-1 levels are associated with hospital readmission, development of complications of cirrhosis, and mortality. These results suggest that in cirrhosis there is an inflammatory response that is associated with poor outcomes. FAU - Graupera, Isabel AU - Graupera I AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Sola, Elsa AU - Sola E AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Fabrellas, Nuria AU - Fabrellas N AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - School of Nursing, University of Barcelona, Barcelona, Spain. FAU - Moreira, Rebeca AU - Moreira R AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Sole, Cristina AU - Sole C AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Huelin, Patricia AU - Huelin P AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - de la Prada, Gloria AU - de la Prada G AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. FAU - Pose, Elisa AU - Pose E AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Ariza, Xavier AU - Ariza X AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. FAU - Risso, Alessandro AU - Risso A AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. FAU - Albertos, Sonia AU - Albertos S AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. FAU - Morales-Ruiz, Manuel AU - Morales-Ruiz M AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. AD - Biochemistry and Molecular Genetics Department, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Department of Physiological Sciences, University of Barcelona, Barcelona, Spain. FAU - Jimenez, Wladimiro AU - Jimenez W AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. AD - Biochemistry and Molecular Genetics Department, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Department of Physiological Sciences, University of Barcelona, Barcelona, Spain. FAU - Gines, Pere AU - Gines P AD - Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Barcelona, Spain. LA - eng PT - Journal Article DEP - 20160630 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Biomarkers) RN - 0 (Chemokine CCL2) RN - 0 (Fatty Acid-Binding Proteins) RN - 0 (Trefoil Factor-3) RN - 106441-73-0 (Osteopontin) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Biomarkers/urine MH - Chemokine CCL2/blood/*urine MH - Fatty Acid-Binding Proteins/urine MH - Female MH - Humans MH - Liver Cirrhosis/blood/*mortality/urine MH - Male MH - Middle Aged MH - Osteopontin/urine MH - Patient Discharge MH - Patient Readmission MH - Predictive Value of Tests MH - Prognosis MH - Survival Rate MH - Trefoil Factor-3/urine MH - Young Adult PMC - PMC4928797 COIS- Competing Interests: Pere Gines (PG) has received research funding from Ferring Pharmaceuticals, Grifols S.A, and Sequana Medical previously. He has participated on Advisory Boards for Noorik, Ikaria, Ferring Pharmaceuticals, Promethera and Sequana Medical. This does not alter the authors's adherence to the PLOS ONE policies on data sharing and materials. EDAT- 2016/07/01 06:00 MHDA- 2017/07/25 06:00 PMCR- 2016/06/30 CRDT- 2016/07/01 06:00 PHST- 2015/12/30 00:00 [received] PHST- 2016/05/28 00:00 [accepted] PHST- 2016/07/01 06:00 [entrez] PHST- 2016/07/01 06:00 [pubmed] PHST- 2017/07/25 06:00 [medline] PHST- 2016/06/30 00:00 [pmc-release] AID - PONE-D-15-56351 [pii] AID - 10.1371/journal.pone.0157371 [doi] PST - epublish SO - PLoS One. 2016 Jun 30;11(6):e0157371. doi: 10.1371/journal.pone.0157371. eCollection 2016.