Peritoneal Level of CD206 Associates With Mortality and an Inflammatory Macrophage Phenotype in Patients With Decompensated Cirrhosis and Spontaneous Bacterial Peritonitis

Stengel, Sven; Quickert, Stefanie; Lutz, Philipp; Ibidapo-Obe, Oluwatomi; Steube, Arndt; Köse-Vogel, Nilay; Yarbakht, Melina; Reuken, Philipp; Busch, Martin; Brandt, Annette; Bergheim, Ina; Deshmukh, S. D.; Stallmach, Andreas; Bruns, Tony

doi:10.1053/j.gastro.2020.01.029

Cited by 28 publications

(47 citation statements)

References 36 publications

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“…Decompensated cirrhotic patients also had impaired immune response to infection [ 2 , 22 ]. Portal hypertension leads to the imbalance of intestinal flora and intestinal barrier dysfunction [ 23 ], cytokine storm, and disorders of portal hemodynamics, all of which could accelerate acute liver function failure [ 22 ]. All those mentioned factors contributed to a higher proportion of severely illness and mortality in those patients.…”

Section: Discussionmentioning

confidence: 99%

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

Xiao

Shi

et al. 2021

Virulence

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Background: COVID-19 has rapidly become a major health emergency worldwide. The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear. Methods: Medical records were collected from 23 Chinese hospitals. Patients with decompensated cirrhosis and age-and sex-matched non-liver disease patients were enrolled with 1:4 ratio using stratified sampling. Results: There were more comorbidities with higher Chalson Complication Index (p < 0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p < 0.05) and in decompensated cirrhosis patients. Mortality (p < 0.05) and the proportion of severe ill (p < 0.001) were significantly high among those patients. Patients in severe ill subgroup had higher mortality (p < 0.001), MELD, and CRUB65 score but lower lymphocytes count. Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p < 0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance. Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome. Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores. Conclusions: COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality. MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.

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Section: Discussionmentioning

confidence: 99%

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

Xiao

Shi

et al. 2021

Virulence

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“…Pro-and anti-inflammatory cytokine levels are elevated in the circulation and certain tissue compartments, such as the peritoneum, in decompensated cirrhosis. 23,24,54 Certain cytokines, such as IL-6 and IL-8, have been associated with the development of ACLF. In addition, elevated IL-10 and IL-1 levels have been correlated with negative outcomes in patients with organ failure.…”

Section: Decompensated Cirrhosismentioning

confidence: 99%

The multifactorial mechanisms of bacterial infection in decompensated cirrhosis

Merwe

Chokshi

Bernsmeier

et al. 2021

Journal of Hepatology

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Infections, due to a dysfunctional immune response, pose a great risk to patients with decompensated cirrhosis and herald the beginning of the terminal phase of this disease. Infections typically result from breaches in innate immune barriers and inadequate clearance by immune cells. This leads to bacterial and bacterial product translocation to the systemic circulation, which is already primed by ongoing hepatic inflammation in patients with cirrhosis, who are particularly prone to developing organ failure in the presence of an infection. Early identification of bacterial infection, along with the prompt use of appropriate antibiotics, have reduced the mortality associated with certain infections in patients with decompensated cirrhosis. Judicious use of antibiotic therapy remains imperative given the emergence of multidrug-resistant infections in the cirrhotic population. Important research over the last few years has identified molecular targets on immune cells that may enhance their function, and theoretically prevent infections. Clinical trials are ongoing to delineate the beneficial effects of targeted molecules from their off-target effects. Herein, we review the mechanisms that predispose patients with cirrhosis to bacterial infections, the clinical implications of infections and potential targets for the prevention or treatment of infections in this vulnerable population.

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“…Recently, sCD206 has been quantified in ascites fluid from cirrhosis patients with spontaneous bacterial peritonitis. The ascites fluid sCD206 concentration is a marker of peritoneal macrophage activation and peritoneal inflammation, and may be a predictor of reduced 90-day survival [102].…”

Section: Scd206 In Liver Diseasesmentioning

confidence: 99%

Macrophage Activation Markers, CD163 and CD206, in Acute-on-Chronic Liver Failure

Nielsen

Gantzel

Clària

et al. 2020

Cells

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Macrophages facilitate essential homeostatic functions e.g., endocytosis, phagocytosis, and signaling during inflammation, and express a variety of scavenger receptors including CD163 and CD206, which are upregulated in response to inflammation. In healthy individuals, soluble forms of CD163 and CD206 are constitutively shed from macrophages, however, during inflammation pathogen- and damage-associated stimuli induce this shedding. Activation of resident liver macrophages viz. Kupffer cells is part of the inflammatory cascade occurring in acute and chronic liver diseases. We here review the existing literature on sCD163 and sCD206 function and shedding, and potential as biomarkers in acute and chronic liver diseases with a particular focus on Acute-on-Chronic Liver Failure (ACLF). In multiple studies sCD163 and sCD206 are elevated in relation to liver disease severity and established as reliable predictors of morbidity and mortality. However, differences in expression- and shedding-stimuli for CD163 and CD206 may explain dissimilarities in prognostic utility in patients with acute decompensation of cirrhosis and ACLF.

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Peritoneal Level of CD206 Associates With Mortality and an Inflammatory Macrophage Phenotype in Patients With Decompensated Cirrhosis and Spontaneous Bacterial Peritonitis

Cited by 28 publications

References 36 publications

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

The multifactorial mechanisms of bacterial infection in decompensated cirrhosis

Macrophage Activation Markers, CD163 and CD206, in Acute-on-Chronic Liver Failure

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