Ascites’ neutrophil function is significantly impaired in patients with decompensated cirrhosis but can be restored by autologous plasma incubation

Systemic immune cell dysfunction is a typical feature of liver diseases and increases the risk of bacterial infection, especially spontaneous bacterial peritonitis. We evaluated functional properties of neutrophil granulocytes in blood and ascites of patients both with and without decompensated cirrhosis. We collected blood and ascites samples from 63 patients with cirrhosis and eight without cirrhosis. Phagocytosis activity (PA) and oxidative burst activity (OBA) were evaluated after ex vivo stimulation with E. coli, while fluorescence signals were measured by flow cytometry. Ascites' neutrophil function tests were repeated after incubation with autologous plasma. Ascites' neutrophils showed an impaired PA and OBA (median blood PA 98.1% (86.8-99.8) vs. ascites' PA 50.5% (0.4-97.3), p < 0.0001; median blood OBA 98.7% (27.5-100) vs. ascites' OBA 27.5% (0.3-96.7), p < 0.0001). Patients with non-cirrhotic ascites showed higher PA but equally suppressed OBA. Ascites' neutrophil function could be partially restored after incubation with autologous plasma (median increase PA: 22.5% (-49.7 - +93.2), p = 0.002; OBA: 22.8% (-10.4 - +48.8), p = 0.002). Ascites' neutrophils of patients with cirrhosis are functionally impaired, but could be partially restored after incubation with plasma. Further investigations are needed to identify the factors in ascites that are associated with neutrophils' function.