Interleukin-22 (IL-22) is associated with progression to Acute-on-Chronic Liver Failure (ACLF) and short-term mortality in cirrhosis

Background and Aims IL-22 has the ability to promote hepatoprotective or adverse properties. Schwarzkopf et al. characterized the role of IL-22 in ACLF. We analyzed associations between IL-22 plasma levels and clinical endpoints of patients with liver cirrhosis with focus on ACLF dynamic.

Method Clinical data of patients (N=204) with liver cirrhosis in respect to ACLF were analyzed retrospectively. IL-22 plasma concentrations were quantified at baseline and associated with clinical endpoints. Plasma levels of IL-22 were measured using ELISA.

Results Plasma levels of IL-22 were almost identical in patients with compensation compared with healthy controls. Patients with decompensation showed significantly higher IL-22 levels (healthy vs. decomp., P=0,005) with further increase in patients with ACLF (healthy vs. ACLF, P=<0,0001). Different courses of decompensation (chronic, acute stable, acute unstable) showed no significant changes in IL-22, whereas patients with pre-ACLF showed significantly higher IL-22 plasma concentrations in comparison to acute unstable decompensated patients (P=0,0014). Further analysis revealed that IL-22 concentrations were low in patients without current ACLF and without progression to ACLF. Patients who recovered from ACLF during the observation period of 90 days showed intermediate IL-22 plasma levels. Highest IL-22 concentrations were observed in patients with stable ACLF and progression to ACLF within 90 days. Furthermore, IL-22 plasma levels were significantly higher in patients who died within 30 days independent of the presence of ACLF.

Conclusion IL-22 shows strong association with adverse outcomes of liver cirrhosis suggesting the use of IL-22 as a biomarker for prediction of ACLF dynamic.

Publication History

Article published online:
20 January 2025