Soluble Interleukin-1 Receptor Type 2 as a Marker of Inflammation and Disease Severity in Patients with Cirrhosis

Introduction: Cirrhosis involves immune dysfunction and systemic inflammation, especially during acute decompensation (AD) and acute-on-chronic liver failure. Soluble interleukin-1 receptor type 2 (sIL-1R2) acts as a decoy receptor for IL-1β with anti-inflammatory effects, but its role in cirrhosis is unclear. Our aim was to assess serum sIL-1R2 levels in patients with cirrhosis, compare them across disease stages and healthy controls, and examine associations with inflammation, bacterial infection, organ failure, and short-term mortality. Methods: We studied 240 individuals: 200 hospitalized with AD, 20 with stable cirrhosis, and 20 healthy controls. Serum sIL-1R2 was measured by ELISA. Clinical data, infection, organ failure, and 30-day outcomes were analyzed using Cox regression and Kaplan-Meier methods. Results: sIL-1R2 levels were significantly higher in AD patients than in stable cirrhotics or controls (p < 0.05). Levels correlated with leukocyte and neutrophil counts, liver function scores (Child-Pugh, MELD, CLIF-SOFA), and were elevated in cases of liver and coagulation failure. Among infected patients, the Kaplan-Meier survival probability was 81.6% in sIL-1R2 <8,300 pg/mL and 57.1% in values ≥8,300 pg/mL (p = 0.009). Conclusions: Serum sIL-1R2 increases with cirrhosis severity and may reflect inflammation and organ failure. It may serve as a short-term prognostic biomarker in infected patients.