Interleukin-22 is associated with progression to acute-on-chronic liver failure and short-term mortality in cirrhosis
- 1Department of Internal Medicine II, LMU University Hospital, Munich, Germany
- 2Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
Abstract
Background and aimsEmerging data show a high potential of prognostic biomarkers in decompensated cirrhosis. Previously, an association between IL-22 and adverse outcomes of decompensated cirrhosis has been shown, but these findings are still to be validated. We therefore analyzed associations between IL-22 plasma levels and clinical endpoints of patients with different patterns of decompensated cirrhosis.MethodsA post-hoc analysis of consecutive, hospitalized patients with liver cirrhosis was performed. Baseline IL-22 plasma concentrations were quantified and correlated with disease stage and clinical endpoints observed over a 90-day follow-up period.ResultsA total of 254 patients were included in the present study. Plasma IL-22 concentrations in patients with compensated cirrhosis were comparable to those of healthy controls. In contrast, patients experiencing decompensation showed significantly higher IL-22 levels (compensated vs. decompensated, p = 0.004; healthy vs. decompensated, p = 0.014), with further increases noted in those with ACLF (healthy vs. ACLF, p < 0.0001). Of note, patients classified as pre-ACLF demonstrated significantly higher IL-22 concentrations in comparison to chronic, acute stable, and acute unstable decompensated cirrhosis, with a cohort-derived threshold of 11.94 pg/mL showing the highest Youden index for pre-ACLF (AUC = 0.75, 95% CI: 0.67–0.83; p < 0.0001; sensitivity 82%, specificity 63%). Furthermore, IL-22 plasma levels were significantly higher in patients who died within 30 or 90 days (p = 0.0018 and p = 0.0002). In subgroup analyses this association was confined to patients with ACLF at 30 days (p = 0.043) and to patients without ACLF at 90 days (p = 0.011), but it was not observed within the pre-ACLF subgroup.ConclusionsIL-22 is associated with adverse outcomes and mortality in liver cirrhosis. Moreover, IL-22 concentrations discriminated pre-ACLF from the other courses of acute decompensation. As all thresholds were derived within the present cohort and were not externally validated, these findings are exploratory and need further analysis.
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BibTeX
@article{mareljic2026interleukin22,
title = {{Interleukin-22 is associated with progression to acute-on-chronic liver failure and short-term mortality in cirrhosis}},
author = {Nikola Mareljic and Mona-May Langer and Lena S. Oeckl and Marc J. Weiß and Julian Allgeier and Helena Stadler and Quan Yin and Alina Bauschen and Nicholas Zeuzem and Christiana Graf and Christian M. Lange},
journal = {Frontiers in Medicine},
year = {2026},
month = nov,
doi = {10.3389/fmed.2026.1977342},
url = {https://doi.org/10.3389/fmed.2026.1977342},
note = {CC BY},
}
RIS
TY - JOUR
TI - Interleukin-22 is associated with progression to acute-on-chronic liver failure and short-term mortality in cirrhosis
AU - Nikola Mareljic
AU - Mona-May Langer
AU - Lena S. Oeckl
AU - Marc J. Weiß
AU - Julian Allgeier
AU - Helena Stadler
AU - Quan Yin
AU - Alina Bauschen
AU - Nicholas Zeuzem
AU - Christiana Graf
AU - Christian M. Lange
PY - 2026
DA - 2026/11/03
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1977342
UR - https://doi.org/10.3389/fmed.2026.1977342
AB - Background and aimsEmerging data show a high potential of prognostic biomarkers in decompensated cirrhosis. Previously, an association between IL-22 and adverse outcomes of decompensated cirrhosis has been shown, but these findings are still to be validated. We therefore analyzed associations between IL-22 plasma levels and clinical endpoints of patients with different patterns of decompensated cirrhosis.MethodsA post-hoc analysis of consecutive, hospitalized patients with liver cirrhosis was performed. Baseline IL-22 plasma concentrations were quantified and correlated with disease stage and clinical endpoints observed over a 90-day follow-up period.ResultsA total of 254 patients were included in the present study. Plasma IL-22 concentrations in patients with compensated cirrhosis were comparable to those of healthy controls. In contrast, patients experiencing decompensation showed significantly higher IL-22 levels (compensated vs. decompensated, p = 0.004; healthy vs. decompensated, p = 0.014), with further increases noted in those with ACLF (healthy vs. ACLF, p < 0.0001). Of note, patients classified as pre-ACLF demonstrated significantly higher IL-22 concentrations in comparison to chronic, acute stable, and acute unstable decompensated cirrhosis, with a cohort-derived threshold of 11.94 pg/mL showing the highest Youden index for pre-ACLF (AUC = 0.75, 95% CI: 0.67–0.83; p < 0.0001; sensitivity 82%, specificity 63%). Furthermore, IL-22 plasma levels were significantly higher in patients who died within 30 or 90 days (p = 0.0018 and p = 0.0002). In subgroup analyses this association was confined to patients with ACLF at 30 days (p = 0.043) and to patients without ACLF at 90 days (p = 0.011), but it was not observed within the pre-ACLF subgroup.ConclusionsIL-22 is associated with adverse outcomes and mortality in liver cirrhosis. Moreover, IL-22 concentrations discriminated pre-ACLF from the other courses of acute decompensation. As all thresholds were derived within the present cohort and were not externally validated, these findings are exploratory and need further analysis.
SN - 2296-858X
ER -