Correlation between Vitamin D Receptor and Monocyte Chemotactic Protein-1 Polymorphisms and Spontaneous Bacterial Peritonitis in Decompensated Liver Disease

Abstract

Spontaneous bacterial peritonitis (SBP) is a serious morbidity complicating chronic liver disease. Vitamin D insufficiency may lead to increase in incidence of infections in cirrhotic patients’ especially spontaneous bacterial peritonitis, besides; infections and inflammation are combined with the presence of monocyte chemotactic protein-1 (MCP-1). In this study, we intended to investigate whether MCP-1 and vitamin D receptor (VDR) polymorphisms are associated with increased incidence of SBP in cirrhotic patients. Additionally, we aimed to assess the levels of vitamin D, MCP-1 and other biochemical markers in such patients. A prospective case control study was performed on (60) patients with post-hepatitis C virus decompensated liver disease divided into Group I (n=30) patients with SBP and Group II (n=30) patients with no SBP; and a control group of 30 healthy volunteers. Our study revealed that MCP-1 and VDR polymorphisms heterozygote genotypes AG in MCP-1 and Ff in VDR were mostly linked to SBP patients. Conversely, one homozygous genotype was linked to cirrhotic GG in MCP-1 and ff in VDR, while the other was linked to the remaining healthy controls AA in MCP-1 and FF in VDR. A and F alleles may be considered protective factors in healthy controls, while G and f alleles may be considered risk factors. Serum vitamin D was significantly lower and MCP-1 (both serum and ascitic fluid) was significantly higher in SBP group in comparison to cirrhotic and control groups. Higher level of MCP-1 could be an early predictor of SBP. Vitamin D deficiency in cirrhotic patients may be among risk factor for SBP