Cirrhotics with Monocyte Chemotactic Protein 1 Polymorphism are at Higher Risk for Developing Spontaneous Bacterial Peritonitis - A Cohort Study.

Background Spontaneous bacterial peritonitis (SBP) is a complication of liver cirrhosis and its occurrence portends poor patient survival. There is emerging evidence that genetic predisposition could significantly alter the occurrence and course of SBP. Monocyte chemotactic protein 1 (MCP1) is a potent chemokine that perpetuates the pro-inflammatory milieu in SBP. Aim This study aimed at investigating MCP1 genotype polymorphism and its survival impact in patients with decompensated liver cirrhosis. Methods We recruited 107 individuals with decompensated liver cirrhosis and categorized them into two groups. Patients having SBP formed the cases (Group 1) and controls were patients without SBP (Group 2). MCP1 polymorphism (-2518A/G) was assessed in both groups by restriction fragment length polymorphism method. The Chi-square test was used to assess the differences in categorical variables and Kaplan-Meier analyses were used to assess the survival. Results Patients with SBP (36.5%) had higher frequency of G allele than patients without SBP (23%) (P=0.031; odds ratio=1.955, 95% confidence interval: 1.0553-3.6216). Kaplan-Meir analysis revealed that presence of SBP (P=0.030) and G allele (P=0.021) had significantly reduced the likelihood of survival among cirrhotics. Conclusions Cirrhotic patients with MCP1 G allele have a higher risk for developing SBP. In general, the presence of the MCP1 polymorphic G allele (AG/GG genotype) reduced the likelihood of survival among patients with cirrhosis. Relevance for Patients This study identifies a critical subgroup of patients with SBP and also predicts prognosis in these individuals. The presence of this genetic polymorphism in addition to the underlying clinical condition may prompt aggressive monitoring, treatment, and follow-up.