Work

A novel sweat sensor detects inflammatory differential rhythmicity patterns in inpatients and outpatients with cirrhosis

Year: 2024

Type: article

Abstract: Cirrhosis is the end stage result of chronic liver injury and clinical events are driven by worsening of complex inflammatory pathways leading to frequent hospitalizations and death or need for liver transplantation. Inflammatory biomarkers such as c-reactive protein (CRP), tumor necrosis factor alpha (TNFα) and interleukin-6 (IL6) are typically elevated in serum of cirrhosis patients and associated with worse outcomes. These markers are not routinely checked due to the invasive nature of blood draws and difficulty in interpretation of a single measurement. Therefore, we designed a study to measure these biomarkers using a continuous monitor of passively expressed sweat in a well characterized cohort of subjects with cirrhosis. We enrolled 32 patients with cirrhosis and 12 controls. The AWARE sweat sensor was placed on each subject with the sensor staying in continuous contact with the skin and exchanged daily for 3 days. Serum lab draws to measure CRP, TNFα, IL6, and liver function were performed along with quality-of-life surveys and hepatic encephalopathy testing. We found that CRP, TNFα, and IL6 were correlated in sweat and serum among cirrhosis and controls. All three biomarkers in sweat and serum were elevated in inpatients compared with outpatients or controls. IL6, whether measured in sweat or serum, was associated with lower transplant-free survival. Continuous monitoring of sweat showed nocturnal elevations of CRP and IL6 when compared to healthy controls. Outpatients with cirrhosis were consistently found to have inflammation levels starting to elevate during the evening periods and peaking towards the early night periods. The levels start to fall much later in the night periods and early morning periods. These data suggest that further investigation of continuous measurement of sweat biomarkers in patients with cirrhosis is warranted.

Source: npj Digital Medicine

DOI: 10.1038/s41746-024-01404-1