Cirrhosis-associated immune dysfunction.

Albillos, Agustín; Martin-Mateos, Rosa; Van der Merwe, Schalk; Wiest, Reiner; Jalan, Rajiv; Álvarez-Mon, Melchor (2022). Cirrhosis-associated immune dysfunction. Nature reviews, 19(2), pp. 112-134. Springer Nature 10.1038/s41575-021-00520-7

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The term cirrhosis-associated immune dysfunction (CAID) comprises the distinctive spectrum of immune alterations associated with the course of end-stage liver disease. Systemic inflammation and immune deficiency are the key components of CAID. Their severity is highly dynamic and progressive, paralleling cirrhosis stage. CAID involves two different immune phenotypes: the low-grade systemic inflammatory phenotype and the high-grade systemic inflammatory phenotype. The low-grade systemic inflammatory phenotype can be found in patients with compensated disease or clinical decompensation with no organ failure. In this phenotype, there is an exaggerated immune activation but the effector response is not markedly compromised. The high-grade systemic inflammatory phenotype is present in patients with acute-on-chronic liver failure, a clinical situation characterized by decompensation, organ failure and high short-term mortality. Along with high-grade inflammation, this CAID phenotype includes intense immune paralysis that critically increases the risk of infections and worsens prognosis. The intensity of CAID has important consequences on cirrhosis progression and correlates with the severity of liver insufficiency, bacterial translocation and organ failure. Therapies targeting the modulation of the dysfunctional immune response are currently being evaluated in preclinical and clinical studies.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Wiest, Reiner

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-5053

Publisher:

Springer Nature

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

09 Nov 2021 08:33

Last Modified:

05 Dec 2022 15:54

Publisher DOI:

10.1038/s41575-021-00520-7

PubMed ID:

34703031

BORIS DOI:

10.48350/160484

URI:

https://boris.unibe.ch/id/eprint/160484

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