Endotoxemia and Serum CD163 in Decompensated Liver Cirrhosis: Associations with Disease Severity and Survival Outcomes | ||||
| Egyptian Journal of Medical Microbiology | ||||
| Article 62, Volume 35, Issue 1, January 2026 | ||||
| Document Type: New and original researches in the field of Microbiology. | ||||
| DOI: 10.21608/ejmm.2025.401913.1765 | ||||
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| Authors | ||||
Walid I. Elsayed1; Amany S. Elyamany1; Ahmed E. Zeid1; Esraa M. Elsharkawy1; Yara S. Roshdy   2
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| 1Internal Medicine Department, Faculty of Medicine, University of Alexandria, Egypt | ||||
| 2Medical Microbiology and Immunology, Faculty of Medicine, University of Alexandria, Egypt | ||||
| Abstract | ||||
| Background: Liver cirrhosis ranks as the tenth leading cause of mortality in Africa. Decompensation marks disease progression, often involving systemic inflammation and bacterial translocation that contribute to hepatic injury. Objective: This study aimed to evaluate the relationship between s CD163 and LPS-binding protein (LBP) levels with severity of liver disease and 6-month survival in cirrhotic cases with decompensation and acute-on-chronic liver failure (ACLF). Methodology: Fifty liver disease cases were enrolled from the Hepatobiliary unit at Faculty of Medicine, Alexandria University and categorized into acute decompensation (AD) (Group A), acute-on-chronic liver failure (ACLF) (Group B), and chronic liver decompensation (Group C). Forty age- and sex-matched healthy individuals were included. Severity of the liver disease was assessed and serum CRP, sCD163, and LBP levels were detected by ELISA at admission, with follow-up at 1 and 6 months. Results: Patients exhibited significantly higher levels of CRP, sCD163, and LBP than healthy controls. (all p ≤ 0.001). However, none of the markers could distinguish ACLF from other decompensation types. In AD patients, sCD163 correlated strongly with scores of disease severity (Child, MELD, CLIF-SOFA), but not in ACLF. At a cutoff >1235.909 pg/mL, sCD163 predicted mortality with 82.14% sensitivity and 68.18% specificity. Median survival at this level was 3 months (p 0.001). sCD163 emerged as the sole independent predictor of mortality at both 1 and 6 months (p < 0.001). Conclusion: sCD163 serves as an independent prognostic marker for mortality in decompensated liver cirrhosis patients. | ||||
| Keywords | ||||
| sCD163; lipopolysaccharide-binding protein; decompensated cirrhosis; endotoxemia | ||||
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