Role of Cytokines in the Pathophysiology of Acute-on-Chronic Liver Failure

Abstract

Background: This is the first ever decade which has witnessed the emergence of a highly lethal condition termed acute-on-chronic liver failure (ACLF), which today is the leading cause of death compared to acute and chronic liver failure. However, the complex pathophysiology of ACLF remains poorly understood. This article will attempt to summarize recent progress in the understanding of the mechanisms of cytokines in ACLF. Methods: The search terms used on PubMed were cytokines, liver injury, complications of liver disease, and hepatic progenitor cell. Results: Cytokines play a significant role in the pathophysiology of ACLF including hepatocellular death, extrahepatic complications and hepatocyte regeneration. The tissue-damaging mechanisms of cytokines are closely related to their hepatocyte proliferation and regeneration function. Conclusions: It remains a challenge to selectively prevent the detrimental effects of cytokines. To design interventions which selectively target the detrimental effects of cytokines, a detailed understanding of cytokines in the pathophysiology ACLF is critical.

Therapeutic mechanisms of granulocyte-colony stimulating factor in methotrexate-induced parotid lesion in adult rats and possible role of telocytes: A histological study

“…This suggestion was stated previously while treated renal ischemia by G-CSF [57] . Furthermore, this is supported by the anti-apoptotic, anti-inflammatory, immunomodulatory and lipid peroxidation inhibiting effects of G-CSF [62][63][64] .…”

Nucleoside Analogue Can Improve the Long-Term Prognosis of Patients with Hepatitis B Virus Infection-Associated Acute on Chronic Liver Failure

“…As a result of previous studies it is believed that an overwhelming immune reaction is involved in the pathogenesis of HBV-associated ACLF [31,32]. The rationale behind use of an oral antiviral agent is direct suppression of HBV DNA, which, hopefully, can calm down the immune activity and buy time for the hepatitis to settle [33].…”

Interleukin-1 receptor antagonist expression is inversely associated with outcomes of hepatitis B-related acute-on-chronic liver failure

“…Although the complete pathophysiology of ACLF is not yet fully understood, uncontrolled hepatic immunoactivation, in particular the disorder of cytokines is thought to be the primary underlying pathological mechanism (6). In China, >96% of ACLF cases are associated with HBV (7). The underlying mechanisms of HBV-induced immunopathological damage leading to liver failure remain unclear; therefore, investigating the changes in cytokine expression patterns in patients with HB-ACLF may facilitate the understanding of this underlying pathogenesis.…”