Evidence of neutrophil functional defect despite inflammation in stable cirrhosis

Fatal cryptococcal meningitis in a HIV‐seronegative patient with liver cirrhosis

“…However, even in early stage cirrhosis, the risk of opportunistic infection is high. In patients such as this the phagocytic activity of neutrophils is reduced at the site of injury (Tritto et al, 2011), and they frequently have decreased complement levels, which reduces opsonizing capacity and neutrophil chemotaxis (Mabee et al, 1995). This suppression of the immune system leaves the individual susceptible to infection (Hsu & Leevy, 1971;Nouri-Aria et al, 1986).…”

The role of neutrophils in the development of liver diseases

“…43 Recently, there has been evidence that a functional defect in neutrophils occurs even in stable cirrhosis, which is characterized by the release of inflammatory mediators into inflamed peripheral tissues. 44 A previous study of alcoholic patients with cirrhosis showed that neutrophils with an increased oxidative burst and reduced phagocytic capacity were associated with infection, organ failure and mortality. However, the neutrophil dysfunction was reversible using endotoxin-removal strategies.…”

Microbiota, cirrhosis, and the emerging oral-gut-liver axis

“…In alcoholic cirrhosis, duodenal and jejunal injury has been documented along with increased intercellular space in tight junctions in the distal duodenum (18,19). Other impairment of intestinal defense mechanisms, such as reduced secretory IgA (20) and generalized reductions in immunity (21), could further weaken the intestinal barrier, resulting in translocation of bacteria and their products. Bacterial products -such as endotoxins, peptidoglycans, and microbial DNA, referred to as pathogen-associated molecular patterns (PAMPs) -gain access to the intestinal immune system due to an increased intestinal permeability.…”