Pathogenesis of Acute‐on‐Chronic Liver Failure in Patients With Infection

Szabó, Gyöngyi

doi:10.1002/cld.826

Cited by 4 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the pathogenesis of liver failure, two factors were inter‐related and mutually constrained, namely systemic inflammation and immunodeficiency. Owing to bacterial translocation from the intestine, Kupffer cells are activated by the released pathogen‐associated molecular patterns, thus triggering the inflammatory reaction, causing impaired hepatic clearance, and ultimately leading to immune paralysis 39‐41 . HBV‐ACLF patients are susceptible to bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to bacterial translocation from the intestine, Kupffer cells are activated by the released pathogen-associated molecular patterns, thus triggering the inflammatory reaction, causing impaired hepatic clearance, and ultimately leading to immune paralysis. [39][40][41] HBV-ACLF patients are susceptible to bacterial infections. The main infection type in this study was spontaneous bacterial peritonitis, which can aggravate sepsis and AKI.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of artificial liver support system on short‐term prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure

et al. 2020

View full text Add to dashboard Cite

Hepatitis B virus‐related acute‐on‐chronic liver failure (HBV‐ACLF) is difficult to treat and carries a high risk of short‐term mortality. This study aimed to explore the effect of artificial liver support system (ALSS) on the survival of HBV‐ACLF patients and to investigate which HBV‐ACLF patients may benefit from ALSS treatment. We enrolled 132 patients hospitalized for HBV‐ACLF according to the criteria of the Chinese Group on the Study of Severe Hepatitis B‐ACLF (COSSH‐ACLF) from 425 ACLF patients who were determined to at least meet the Asian Pacific Association for the Study of the Liver criteria and followed up for 90 days. Overall 132 eligible patients were divided into two groups: standard medical treatment (SMT) group, which included 54 patients who underwent SMT alone, and ALSS group, which included 78 patients who underwent ALSS treatment plus SMT. The proportion of HBV‐ACLF grade 1, 2, and 3 was 57.69%, 37.18%, and 5.13% in the ALSS group and 51.85%, 35.19%, and 12.96% in the SMT group, respectively. Bacterial infection was present in 43.6% of patients in the ALSS group and in 55.6% of patients in the SMT group. The mortality rates in the ALSS group at 28 and 90 days were significantly lower than those in the SMT group (23.08% vs. 48.15% and 33.33% vs. 57.41%, P < 0.05). ALSS was an independent factor related to both the 28‐ and 90‐day survival of HBV‐ACLF patients. Particularly, a higher cumulative survival rate in either patients with HBV‐ACLF grade 1 or those with HBV‐ACLF with bacterial infection was observed in the ALSS group. Moreover, ALSS had an independent influence on mortality. Based on the COSSH‐ACLF criteria, ALSS could better improve the short‐term survival of HBV‐ACLF patients than SMT alone, especially in those with HBV‐ACLF grade 1 or HBV‐ACLF with infection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of artificial liver support system on short‐term prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Systemic inflammation in ACLF is usually induced by damage-associated molecular patterns (DAMPs) and body fluids containing pathogen-associated molecular patterns (PAMPs) [49][50][51]. Bacterial translocation often occurs in cirrhotic patients due to intestinal bacterial overgrowth, increased intestinal mucosa permeability, and impaired intestinal innate immune, and these PAMPs may be a main cause of ACLF [52][53][54]. However, alcohol-induced DAMPs can be activated in the absence of infection, especially in severe alcoholic hepatitis, and can lead to increased endoplasmic reticulum stress and hepatocyte injury [55,56].…”

Section: Pathogenesis Of Acute Kidney Injury In Acute-onchronic-liver...mentioning

confidence: 99%

Acute kidney injury in patients with acute-on-chronic liver failure: clinical significance and management

Yoo

Park

Kim

2023

Kidney Res Clin Pract

View full text Add to dashboard Cite

Acute-on-chronic-liver failure (ACLF) refers to a phenomenon in which patients with chronic liver disease develop multiple organ failure due to acute exacerbation of underlying liver disease. More than 10 definitions of ACLF are extant around the world, and there is lack of consensus on whether extrahepatic organ failure is a main component or a consequence of ACLF. Asian and European consortiums have their own definitions of ACLF. The Asian Pacific Association for the Study of the Liver ACLF Research Consortium does not consider kidney failure as a diagnostic criterion for ACLF. Meanwhile, the European Association for the Study of the Liver Chronic Liver Failure and the North American Consortium for the Study of End-stage Liver Disease do consider kidney failure as an important factor in diagnosing and assessing the severity of ACLF. When kidney failure occurs in ACLF patients, treatment varies depending on the presence and stage of acute kidney injury (AKI). In general, the diagnosis of AKI in cirrhotic patients is based on the International Club of Ascites criteria: an increase of 0.3 mg/dL or more within 48 hours or a serum creatinine increase of 50% or more within one week. This study underscores the importance of kidney failure or AKI in patients with ACLF by reviewing its pathophysiology, prevention methods, and treatment approaches.

show abstract

“…Several precipitating factors, including bacterial infection and binge alcohol intake, are also involved. ( 32 ) Of these factors, increased spontaneous microbial infection correlates with the neutrophil dysfunctions described. Despite different etiologies, neutrophils found in patients with ACLF show similar defects on their functions, such as increased chemokine receptor expressions, higher resting ROS burst, and impaired phagocytosis.…”

Section: Pathogenic Roles Of Neutrophils In Liver Diseasesmentioning

confidence: 99%

Two Faces of Neutrophils in Liver Disease Development and Progression

Cho

Szabó

2021

Hepatology

Self Cite

View full text Add to dashboard Cite

Neutrophils, the most abundant type of leukocyte in human blood, play a major role in host defense against invading pathogens and in sterile injury. Neutrophil infiltration is characteristic of inflammation because of its antimicrobial and cytotoxic activities. Neutrophils also actively participate in the resolution of inflammation and subsequent tissue repair by acting as a critical mediator between the inflammation and resolution phases of tissue damage. However, neutrophils that are consistently exposed to inflammatory conditions lose their self‐resolving capabilities and maintain an inflammatory phenotype, further exacerbating tissue damage. The current review describes how neutrophils interact with tissue microenvironments and acquire disease‐specific phenotypes under chronic inflammatory conditions. Here, we aim to provide a better understanding of neutrophil‐mediated pathogenesis of various liver diseases.

show abstract

Pathogenesis of Acute‐on‐Chronic Liver Failure in Patients With Infection

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/14-3-reading-szabo a video presentation of this article

Cited by 4 publications

References 11 publications

Effect of artificial liver support system on short‐term prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure

Effect of artificial liver support system on short‐term prognosis of patients with hepatitis B virus‐related acute‐on‐chronic liver failure

Acute kidney injury in patients with acute-on-chronic liver failure: clinical significance and management

Two Faces of Neutrophils in Liver Disease Development and Progression

Contact Info

Product

Resources

About