4.5 Review

Liver cirrhosis and immune dysfunction

Journal

INTERNATIONAL IMMUNOLOGY
Volume 34, Issue 9, Pages 455-466

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/intimm/dxac030

Keywords

acute-on-chronic liver failure (ACLF); cirrhosis-associated immune dysfunction (CAID); compensated and decompensated cirrhosis; immune paralysis; inflammation

Categories

Funding

  1. National Institutes of Health (NIH) [K12 HD85036]
  2. University of California San Diego Altman Clinical and Translational Research Institute (ACTRI)/NIH [KL2TR001444]
  3. Pinnacle Research Award in Liver Diseases Grant from the American Association for the Study of Liver Diseases Foundation [PNC22-159963]
  4. NIH [P30 DK120515, P50 AA011999, R01 AA24726, R01 AA020703, U01 AA026939]
  5. Biomedical Laboratory Research & Development Service of the VA Office of Research and Development [BX004594]
  6. Biocodex Microbiota Foundation

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Cirrhosis is a common cause of death worldwide, and it is an end-stage liver disease caused by various factors. The progression of cirrhosis involves the continuation of alcohol or toxin exposure, dysbiosis of gut microbiota, increased gut permeability, and disrupted immune response.
Cirrhosis is end-stage liver disease resulting from various etiologies and is a common cause of death worldwide. The progression from compensated to decompensated cirrhosis to acute-on-chronic liver failure (ACLF) is due to multiple factors, including continuation of alcohol use or continued exposure to other toxins, an imbalance of the gut microbiota (dysbiosis), increased gut permeability and a disrupted immune response. This disrupted immune response is also named cirrhosis-associated immune dysfunction, which is characterized by worsening systemic inflammation with concomitant immune paralysis, as liver disease deteriorates. This review highlights central immunologic events during the exacerbation of cirrhosis and characterizes the different immune cell populations involved therein.

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