Journal of Clinical and Translational Hepatology, Год журнала: 2024, Номер 000(000), С. 000 - 000
Опубликована: Сен. 30, 2024
Early determination of prognosis in patients with acute-on-chronic liver failure (ACLF) is crucial for optimizing treatment options and allocation. This study aimed to identify risk factors associated ACLF develop new prognostic models that accurately predict patient outcomes.
Язык: Английский
Molecular Cancer, Год журнала: 2025, Номер 24(1)
Опубликована: Янв. 24, 2025
Microplastics, as an emerging environmental pollutant, have received widespread attention for their potential impact on ecosystems and human health. Microplastics are defined plastic particles less than 5 millimeters in diameter can be categorized primary secondary microplastics. Primary microplastics usually originate directly from industrial production, while formed by the degradation of larger items. capable triggering cytotoxicity chronic inflammation, may promote cancer through mechanisms such pro-inflammatory responses, oxidative stress endocrine disruption. In addition, improved bring new perspectives to therapy, studies drug carriers underway, showing high targeting bioavailability. Although current suggest association between certain cancers (e.g., lung, liver, breast cancers), long-term effects specific still need studied. This review aimed at exploring carcinogenicity promising applications therapy provides important directions future research emphasizes multidisciplinary collaboration address this global health challenge.
Язык: Английский
Процитировано
6
Fish & Shellfish Immunology, Год журнала: 2025, Номер 157, С. 110114 - 110114
Опубликована: Янв. 9, 2025
Язык: Английский
Процитировано
1
Liver International, Год журнала: 2023, Номер unknown
Опубликована: Сен. 16, 2023
Acute-on-chronic liver failure (ACLF) is a life-threatening syndrome characterized by decompensation of cirrhosis, severe systemic inflammation and organ failures. ACLF frequently triggered intra- and/or extrahepatic insults, such as bacterial infections, alcohol-related hepatitis or flares hepatic viruses. The imbalance between immune tolerance causes failures through the following mechanisms: (i) direct damage cells/mediators; (ii) worsening circulatory dysfunction resulting in hypoperfusion (iii) metabolic alterations with prioritization energetic substrates for peripheral 'energetic crisis'. Currently, management includes support failures, identification treatment precipitating factors expedited assessment transplantation (LT). Early LT should be considered patients grade 3, who are unlikely to recover available treatments have mortality rate > 70% at 28 days. However, selection transplant candidates their on waiting list need standardization. Future challenges field include better understanding pathophysiological mechanisms leading development specific disease personalized approaches. Herein, we reviewed current knowledge future perspectives ACLF.
Язык: Английский
Процитировано
15
Artificial Organs, Год журнала: 2024, Номер 48(10), С. 1150 - 1161
Опубликована: Май 21, 2024
To investigate the efficacy of bilirubin reduction by hemoadsorption with CytoSorb® in patients acute-on-chronic liver failure (ACLF) receiving continuous renal replacement therapy (CRRT).
Язык: Английский
Процитировано
4
International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(4), С. 2073 - 2073
Опубликована: Фев. 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.
Язык: Английский
Процитировано
3
American Journal of Transplantation, Год журнала: 2024, Номер 24(5), С. 724 - 732
Опубликована: Фев. 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.
Язык: Английский
Процитировано
3
Liver International, Год журнала: 2024, Номер unknown
Опубликована: Апрель 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.
Язык: Английский
Процитировано
3
International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(17), С. 9522 - 9522
Опубликована: Сен. 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.
Язык: Английский
Процитировано
3
medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown
Опубликована: Фев. 7, 2025
Abstract Background Patients with acute decompensation (AD) of cirrhosis are at high risk developing acute-on-chronic liver failure (ACLF), a syndrome characterized by multiple organ and short-term mortality. This study aimed to analyse alterations in peripheral blood mononuclear cells (PBMCs) patients AD using single-cell technologies explore their implications for stratification prognosis. Methods A total 63 15 healthy donors were enrolled five European centers, samples collected upon hospital admission. monitored 90 days after inclusion, focusing on readmission related the development ACLF. Cellular indexing transcriptomes epitopes sequencing (CITE-seq) was performed PBMCs from 16 (n=6 without readmission, n=6 n=4 ACLF development) along 4 controls. The whole same assessed bulk RNA-seq. transcriptional profiles two independent prospective multicentre cohorts (PREDICT (n=689) ACLARA (n=521)) included as validation cohorts. Results Cell proportion analysis revealed significant increase classical monocytes subsequent development. Notably, represented cell type highest alterations. Within monocyte population, specific subcluster, termed “C2”, identified found be enriched during progression towards monocytic subpopulation primarily decreased expression genes encoding enzymes relevant cellular energy supply, such oxidative phosphorylation ATP production. Pathway confirmed marked impairment metabolism pathways within C2 subcluster. gene signature derived that significantly increased bacterial infection, non-survivors multicenter AD. Conclusion who subsequently develop exhibiting features impaired pathways.
Язык: Английский
Процитировано
0
Scientific Reports, Год журнала: 2025, Номер 15(1)
Опубликована: Фев. 11, 2025
The impact of neutrophil percentage-to-albumin ratio (NPAR) on the outcome acute-on-chronic liver failure (ACLF) is scant. A retrospective cohort study was conducted in patients with ACLF treated artificial support system (ALSS). diagnosed according to Chinese Group Study Severe Hepatitis B-ACLF (COSSH ACLF) criteria. Disease severity rated COSSH score. Restricted cubic splines, linear or Cox regression models were used investigate relationships baseline NPAR disease and 90-day prognosis. transplant-free overall survival rates 258 eligible 58.5% 66.3%, respectively. survivors lower than that transplant death (22.8 ± 4.4 vs. 25.3 3.7, P < 0.001). positively associated score (adjusted β (95% CI) > 0, 0.001), HR for death: 1.07 (1.02–1.13), = 0.007), 1.09 (1.03–1.15), 0.003). Patients ≥ 22.4 had poor prognosis compared rest (all adjusted 1, 0.05). short-term who underwent ALSS treatment. Thus, it could be as a prognostic biomarker ACLF.
Язык: Английский
Процитировано
0