Immunopathogenesis of acute on chronic liver failure

American Journal of Transplantation, Journal Year: 2024, Volume and Issue: 24(5), P. 724 - 732

Published: Feb. 10, 2024

Acute-on-chronic liver failure is a well-established description of high mortality syndrome chronic disease (usually cirrhosis) with organ failure. While the exact definition under refinement accepted understanding this entity in patients who have various organs and where systemic inflammation major component pathobiology. There are limited therapies for such poor prognosis while improvements critical care management very few patients, transplantation, mean 50% can survive to hospital discharge, rapid application new required. Here we explain current immunological abnormalities seen ACLF across innate adaptive immune systems, role hepatic cell death gut axis recommendations future research treatment paradigms.

Language: Английский

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Prognosis algorithms for acute decompensation of cirrhosis and ACLF

Liver International, Journal Year: 2024, Volume and Issue: unknown

Published: April 9, 2024

Abstract Accurate prediction of survival in patients with cirrhosis is crucial, as who are unlikely to survive the short‐term need be oriented liver transplantation and novel therapeutic approaches. Patients acute decompensation without or organ dysfunction/failure, so‐called acute‐on‐chronic failure (ACLF), have a particularly high mortality. Recognizing specificity this clinical situation, dedicated classifications scores been developed over last 15 years, including variables (e.g. failures systemic inflammation) not part formerly available severity scores, namely Child‐Pugh score MELD. For cirrhosis, it led development score, Clif‐C‐AD independently validated. more severe patients, three different scoring systems proposed, by European, Asian North American societies Clif‐C‐ACLF, AARC NASCELD‐ACLF respectively. These validated, widely used across world. The differences similarities between these well their validation limitations discussed here. Even if step forward favouring homogeneity studies, helping making decisions for individual predictive value mortality can still improved area under ROC curve does exceed .8. Novel biomarkers reflecting pathophysiology might help reach that goal.

Language: Английский

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The Immunoregulatory and Regenerative Potential of Activated Human Stem Cell Secretome Mitigates Acute-on-Chronic Liver Failure in a Rat Model

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(4), P. 2073 - 2073

Published: Feb. 8, 2024

Acute-on-chronic liver failure (ACLF) is a syndrome marked by sudden function decline and multiorgan failure, predominantly acute kidney injury (AKY), in patients with chronic disease. Unregulated inflammation hallmark of ACLF; however, the key drivers ACLF are not fully understood. This study explores therapeutic properties human mesenchymal stem cell (MSC) secretome, particularly focusing on its enhanced anti-inflammatory pro-regenerative after vitro preconditioning cells. We evaluated efficacy systemic administration MSC secretome preventing AKI rat model where disease was induced using porcine serum, followed D-galN/LPS to induce failure. After induction, animals were treated saline (ACLF group) or MSC-derived (ACLF-secretome group). The revealed that MSC-secretome strongly reduced histological damage group, which correlated higher hepatocyte proliferation, increased hepatic molecule levels, neutrophil macrophage infiltration. Additionally, renal examination treatment mitigated tubular injuries, apoptosis, downregulated markers. These improvements linked survival rates ACLF-secretome endorsing secretomes as promising therapy for ACLF.

Language: Английский

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The Impact of Liver Failure on the Immune System

Published: July 29, 2024

Background: Liver failure profoundly affects the immune system, leading to dysregulation of innate and adaptive responses. Body: This review explores intricate relationship between liver function homeostasis. The role as a central hub in response initiation is elucidated, emphasizing its involvement hepatic inflammation induction subsequent systemic inflammation. Cytokines, chemokines, growth factors, lipid mediators orchestrate these processes, serving both prognostic biomarkers potential therapeutic targets failure-associated dysregulation. Furthermore, delves into mechanisms underlying immunosuppression failure, encompassing alterations cell functions such neutrophils, macrophages, natural killer cells (NK cells), well perturbations responses mediated by B T cells. Conclusion: Understanding immunological consequences crucial for developing targeted interventions improving patient outcomes disease management.

Language: Английский

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The Impact of Liver Failure on the Immune System

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(17), P. 9522 - 9522

Published: Sept. 1, 2024

Liver failure profoundly affects the immune system, leading to dysregulation of innate and adaptive response. This review explores intricate relationship between liver function homeostasis. The role as a central hub in response initiation is elucidated, emphasizing its involvement hepatic inflammation induction subsequent systemic inflammation. Cytokines, chemokines, growth factors, lipid mediators orchestrate these processes, serving both prognostic biomarkers potential therapeutic targets failure-associated dysregulation, which might result from acute-on-chronic (ACLF) cirrhosis. Furthermore, delves into mechanisms underlying immunosuppression failure, encompassing alterations cell functions such neutrophils, macrophages, natural killer cells (NK cells), well perturbations responses mediated by B T cells. Conclusion: Understanding immunological consequences crucial for developing targeted interventions improving patient outcomes disease management.

Language: Английский

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Air pollution exposure and plasma fatty acid profile in pregnant women: a cohort study

Environmental Science and Pollution Research, Journal Year: 2023, Volume and Issue: 30(49), P. 108319 - 108329

Published: Sept. 26, 2023

Language: Английский

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Proceedings of the 5th Meeting of Translational Hepatology, organized by the Spanish Association for the Study of the Liver (AEEH)

Gastroenterología y Hepatología, Journal Year: 2024, Volume and Issue: 47(10), P. 502207 - 502207

Published: May 8, 2024

This is the summary report of 5th Translational Hepatology Meeting, endorsed by Spanish Association for Study Liver (AEEH) and held in Seville, Spain, October 2023. The meeting aimed to provide an update on latest advances field basic translational hepatology, covering different molecular, cellular, pathophysiological aspects most relevant clinical challenges liver pathologies. includes identification novel biomarkers diagnostic tools, understanding relevance immune response inflammation diseases, characterization current medical approaches reverse incorporation molecular insights through omics techniques, or impact toxic metabolic insults, as well other organ crosstalk, pathophysiology. Este es el informe resumen de la 5ª Reunión Hepatología Traslacional, organizada por Asociación Española para Estudio del Hígado y celebrada en Sevilla, España, octubre La reunión tuvo como objetivo proporcionar una actualización sobre los últimos avances campo hepatología básica traslacional, cubriendo diferentes aspectos moleculares, celulares fisiopatológicos las necesidades clínicas más relevantes patologías hepáticas. Esto incluye identificación nuevos biomarcadores herramientas diagnóstico, comprensión relevancia respuesta inmune inflamación enfermedades hepáticas, caracterización nuevas aproximaciones revertir incorporación conocimientos moleculares a través enfoques ómicos, o impacto agentes tóxicos alteraciones metabólicas, así interacción con otros órganos, fisiopatología hígado.

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Exploring the interaction between bile acid and intestinal microbiota in acute-on-chronic liver failure and the progress of treatment strategies

Published: April 29, 2024

Acute-on-Chronic Liver Failure (ACLF) is an acute and severe disease involving single or multiple organ failure. Due to the unclear pathogenesis, there still a lack of effective drug treatment. Intestinal microbiota closely related Bile Acid (BA) metabolism. In progression chronic liver ACLF, BA metabolism disorder often accompanied by intestinal imbalance, which affect one another mutually. This article reviewed role in aims explore potential new targets for treatment ACLF.

Language: Английский

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Liver transplantation consideration and evaluation: a life-saving treatment in acute-on-chronic liver failure

Published: July 23, 2024

With the rising prevalence of chronic liver disease worldwide, incidence and acute-on-chronic failure (ACLF) are increasing attribute to higher morbidity, mortality, healthcare costs. Many such patients die without being considered for lifesaving treatment option transplantation. The underutilization transplantation as a therapeutic in setting ACLF, is due multiple reasons; with heterogeneity ACLF lack universal definition key players. Liver listing allocation based on MELD score. As now, we do not know where score stands regard defining prognostication patients. This insight very important efficient identification potential candidates ACLF. review paper investigates role In light recent evidence, perfect model either. safety transplantation, either deceased donor or living donor, among has been debated. short-term mortality rate created need standard transplant selection criterion these Based published literature, find that three commonly used definitions may be combination define sensitivity, specificity, futility propose an algorithm best identify urgent Moreover, discuss data Future validation this multifaceted approach could bridge gap between appropriately guided medical intervention.

Language: Английский

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Experimental study on H2O2 activation of HSC-T6 and hepatic fibrosis in cholestatic mice by "Yajieshaba"

Journal of Ethnopharmacology, Journal Year: 2024, Volume and Issue: 335, P. 118712 - 118712

Published: Aug. 22, 2024

Language: Английский

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