Immune dysfunction in cirrhosis

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, is a major component of cirrhosis, and plays a pivotal role in the pathogenesis of both the acute and chronic worsening of liver function. During the evolution of the disease, acute decompensation events associated with organ failure(s), so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and also development of disease specific complications, comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and increased occurrence of systemic bacterial infections have substantial impacts on both clinical situations. Acute and chronic exposure to bacteria and/or their products, however, can result in variable clinical consequences. The immune status of patients is not constant during the illness; consequently, alterations of the balance between pro- and anti-inflammatory processes result in very different dynamic courses. In this review we give a detailed overview of acquired immune dysfunction and its consequences for cirrhosis. We demonstrate the substantial influence of inherited innate immune dysfunction on acute and chronic inflammatory processes in cirrhosis caused by the pre-existing acquired immune dysfunction with limited compensatory mechanisms. Moreover, we highlight the current facts and future perspectives of how the assessment of immune dysfunction can assist clinicians in everyday practical decision-making when establishing treatment and care strategies for the patients with end-stage liver disease. Early and efficient recognition of inappropriate performance of the immune system is essential for overcoming complications, delaying progression and reducing mortality.

Original languageEnglish
Pages (from-to)2564-2577
Number of pages14
JournalWorld Journal of Gastroenterology
Volume20
Issue number10
DOIs
Publication statusPublished - Mar 14 2014

Fingerprint

Fibrosis
Bacterial Translocation
End Stage Liver Disease
Endotoxemia
Acute Disease
Bacterial Infections
Liver Cirrhosis
Immune System
Decision Making
Patient Care
Anti-Inflammatory Agents
Bacteria
Mortality
Liver
Therapeutics

Keywords

  • Cirrhosis
  • Endotoxemia
  • Immune dysfunction

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Immune dysfunction in cirrhosis. / Sipeki, Nora; Antal-Szalmás, P.; Lakatos, P.; Papp, M.

In: World Journal of Gastroenterology, Vol. 20, No. 10, 14.03.2014, p. 2564-2577.

Research output: Contribution to journalArticle

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