Dysfunctional Immune Response in Acute-on-Chronic Liver Failure: It Takes Two to Tango.
Front Immunol
; 10: 973, 2019.
Article
em En
| MEDLINE
| ID: mdl-31118937
ABSTRACT
Acute-on-chronic liver failure (ACLF) is characterized by the acute decompensation of cirrhosis associated with organ failure and high short-term mortality. The key event in the pathogenesis is a dysfunctional immune response arising from exacerbation of the two main immunological alterations already present in cirrhosis systemic inflammation and immune cell paralysis. High-grade systemic inflammation due to predominant activation and dysregulation of the innate immune response leads to the massive release of cytokines. Recognition of acutely increased pathogen and damage-associated molecular patterns by specific receptors underlies its pathogenesis and contributes to tissue damage and organ failure. In addition, an inappropriate compensatory anti-inflammatory response over the course of ACLF, along with the exhaustion and dysfunction of both the innate and adaptive immune systems, leads to functional immune cell paralysis. This entails a high risk of infection and contributes to a poor prognosis. Therapeutic approaches seeking to counteract the immune alterations present in ACLF are currently under investigation.
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Base de dados:
MEDLINE
Assunto principal:
Insuficiência Hepática Crônica Agudizada
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article