Research advances in the role of inflammatory response and related treatment strategies in acute-on-chronic liver failure

Huaqian XU; Xue LI; Shanhong TANG

doi:10.3969/j.issn.1001-5256.2022.08.041

Volume 38 Issue 8

Aug. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2022 > 38(8): 1927-1930

PDF( 1872 KB)

Research advances in the role of inflammatory response and related treatment strategies in acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.08.041

Huaqian XU^{1, 2},
Xue LI^{1, 2},
Shanhong TANG^{1, 2
,
,
,}

1.
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China
2.
Department of Gastroenterology, The General Hospital of Western Theater Command, Chengdu 610083, China

Research funding:

Scientific Research Project of Sichuan Provincial Health Commission (20PJ180)

More Information

Corresponding author: TANG Shanhong, 15928956390@163.com(ORCID: 0000-0001-6652-2942)
Received Date: 2021-12-29
Accepted Date: 2022-02-17
Published Date: 2022-08-20

Abstract

Abstract

Acute-on-chronic liver failure (ACLF) is a clinical syndrome with rapid deterioration of liver function caused by a series of predisposing factors on the basis of chronic liver diseases, and it is characterized by multiple organ failure and high short-term mortality. The onset of systemic inflammation is one of the important influencing factors for the progression of ACLF and is the body's natural defense against infection; however, the excessive release of inflammatory mediators breaks the original dynamic balance between "pro-inflammation" and "anti-inflammation", which may aggravate liver function impairment and even lead to decompensation. Therefore, the intensity of inflammatory response is closely associated with the prognosis of patients with ACLF, while at present, not enough attention has been paid to the impact of inflammatory response on patients with ACLF and the measures to deal with cytokine storm. Therefore, this article summarizes the impact of inflammatory response on ACLF and related advances in treatment, so as to provide ideas for the diagnosis and treatment of ACLF in clinical practice.
- Acute-On-Chronic Liver Failure,
- Inflammation,
- Therapeutics,
- Prognosis

FullText(HTML)

References(36)

References

[1]	SARIN SK, CHOUDHURY A, SHARMA MK, et al. Correction to: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update[J]. Hepatol Int, 2019, 13(6): 826-828. DOI: 10.1007/s12072-019-09980-1.
[2]	BAJAJ JS, HEUMAN DM, HYLEMON PB, et al. Randomised clinical trial: Lactobacillus GG modulates gut microbiome, metabolome and endotoxemia in patients with cirrhosis[J]. Aliment Pharmacol Ther, 2014, 39(10): 1113-1125. DOI: 10.1111/apt.12695.
[3]	ARROYO V, ANGELI P, MOREAU R, et al. The systemic inflammation hypothesis: Towards a new paradigm of acute decompensation and multiorgan failure in cirrhosis[J]. J Hepatol, 2021, 74(3): 670-685. DOI: 10.1016/j.jhep.2020.11.048.
[4]	TANG SH, ZENG WZ, JIANG MD, et al. Research progress in prediction of clinical outcome in patients with liver failure[J]. J Clin Hepatol, 2015, 31(1): 135-138. DOI: 10.3969/j.issn.1001-5256.2015.01.031. 汤善宏, 曾维政, 蒋明德, 等. 肝衰竭患者临床预后判断研究进展[J]. 临床肝胆病杂志, 2015, 31(1): 135-138. DOI: 10.3969/j.issn.1001-5256.2015.01.031.
[5]	ALBILLOS A, de GOTTARDI A, RESCIGNO M. The gut-liver axis in liver disease: Pathophysiological basis for therapy[J]. J Hepatol, 2020, 72(3): 558-577. DOI: 10.1016/j.jhep.2019.10.003.
[6]	MICHELENA J, ALTAMIRANO J, ABRALDES JG, et al. Systemic inflammatory response and serum lipopolysaccharide levels predict multiple organ failure and death in alcoholic hepatitis[J]. Hepatology, 2015, 62(3): 762-772. DOI: 10.1002/hep.27779.
[7]	CULLARO G, SHARMA R, TREBICKA J, et al. Precipitants of acute-on-chronic liver failure: an opportunity for preventative measures to improve outcomes[J]. Liver Transpl, 2020, 26(2): 283-293. DOI: 10.1002/lt.25678.
[8]	ZACCHERINI G, WEISS E, MOREAU R. Acute-on-chronic liver failure: Definitions, pathophysiology and principles of treatment[J]. JHEP Rep, 2021, 3(1): 100176. DOI: 10.1016/j.jhepr.2020.100176.
[9]	CLÀRIA J, STAUBER RE, COENRAAD MJ, et al. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure[J]. Hepatology, 2016, 64(4): 1249-1264. DOI: 10.1002/hep.28740.
[10]	van WYNGENE L, VANDEWALLE J, LIBERT C. Reprogramming of basic metabolic pathways in microbial sepsis: therapeutic targets at last?[J]. EMBO Mol Med, 2018, 10(8): e8712. DOI: 10.15252/emmm.201708712.
[11]	BAJAJ JS, VARGAS HE, REDDY KR, et al. Association between intestinal microbiota collected at hospital admission and outcomes of patients with cirrhosis[J]. Clin Gastroenterol Hepatol, 2019, 17(4): 756-765. e3. DOI: 10.1016/j.cgh.2018.07.022.
[12]	VILLANUEVA C, ALBILLOS A, GENESCÀ J, et al. Bacterial infections adversely influence the risk of decompensation and survival in compensated cirrhosis[J]. J Hepatol, 2021, 75(3): 589-599. DOI: 10.1016/j.jhep.2021.04.022.
[13]	PIANO S, SINGH V, CARACENI P, et al. Epidemiology and effects of bacterial infections in patients with cirrhosis worldwide[J]. Gastroenterology, 2019, 156(5): 1368-1380. e10. DOI: 10.1053/j.gastro.2018.12.005.
[14]	FERNÁNDEZ J, ACEVEDO J, WIEST R, et al. Bacterial and fungal infections in acute-on-chronic liver failure: prevalence, characteristics and impact on prognosis[J]. Gut, 2018, 67(10): 1870-1880. DOI: 10.1136/gutjnl-2017-314240.
[15]	FERNÁNDEZ J, ANGELI P, TREBICKA J, et al. Efficacy of albumin treatment for patients with cirrhosis and infections unrelated to spontaneous bacterial peritonitis[J]. Clin Gastroenterol Hepatol, 2020, 18(4): 963-973. e14. DOI: 10.1016/j.cgh.2019.07.055.
[16]	CARACENI P, RIGGIO O, ANGELI P, et al. Long-term albumin administration in decompensated cirrhosis (ANSWER): An open-label randomised trial[J]. Lancet, 2018, 391(10138): 2417-2429. DOI: 10.1016/S0140-6736(18)30840-7.
[17]	FERNÁNDEZ J, CLÀRIA J, AMORÓS A, et al. Effects of albumin treatment on systemic and portal hemodynamics and systemic inflammation in patients with decompensated cirrhosis[J]. Gastroenterology, 2019, 157(1): 149-162. DOI: 10.1053/j.gastro.2019.03.021.
[18]	GUSTOT T, JALAN R. Acute-on-chronic liver failure in patients with alcohol-related liver disease[J]. J Hepatol, 2019, 70(2): 319-327. DOI: 10.1016/j.jhep.2018.12.008.
[19]	ARROYO V, MOREAU R, JALAN R. Acute-on-chronic liver failure[J]. N Engl J Med, 2020, 382(22): 2137-2145. DOI: 10.1056/NEJMra1914900.
[20]	ZHANG YC, BI YZ, FANG X, et al. Protective effect of probiotics in rats with acute-on-chronic liver failure and related mechanism[J]. J Clin Hepatol, 2019, 35(7): 1570-1575. DOI: 10.3969/j.issn.1001-5256.2019.07.029. 张永超, 毕研贞, 方萧, 等. 益生菌对慢加急性肝衰竭大鼠模型的保护作用及其机制[J]. 临床肝胆病杂志, 2019, 35(7): 1570-1575. DOI: 10.3969/j.issn.1001-5256.2019.07.029.
[21]	PHILIPS CA, PHADKE N, GANESAN K, et al. Corticosteroids, nutrition, pentoxifylline, or fecal microbiota transplantation for severe alcoholic hepatitis[J]. Indian J Gastroenterol, 2018, 37(3): 215-225. DOI: 10.1007/s12664-018-0859-4.
[22]	MULLISH BH, MCDONALD J, THURSZ MR, et al. Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial[J]. Hepatology, 2017, 66(4): 1354-1355. DOI: 10.1002/hep.29369.
[23]	HARTMANN P, HOCHRATH K, HORVATH A, et al. Modulation of the intestinal bile acid/farnesoid X receptor/fibroblast growth factor 15 axis improves alcoholic liver disease in mice[J]. Hepatology, 2018, 67(6): 2150-2166. DOI: 10.1002/hep.29676.
[24]	GOEL A, RAHIM U, NGUYEN LH, et al. Systematic review with meta-analysis: rifaximin for the prophylaxis of spontaneous bacterial peritonitis[J]. Aliment Pharmacol Ther, 2017, 46(11-12): 1029-1036. DOI: 10.1111/apt.14361.
[25]	ACHARYA C, SAHINGUR SE, BAJAJ JS. Microbiota, cirrhosis, and the emerging oral-gut-liver axis[J]. JCI Insight, 2017, 2(19): e94416. DOI: 10.1172/jci.insight.94416.
[26]	FISCHER P, STEFANESCU H, HATEGAN R, et al. Bacterial infection-related acute-on-chronic liver failure: The standpoint matters![J]. J Hepatol, 2021, 75(4): 1009-1010. DOI: 10.1016/j.jhep.2021.04.046.
[27]	WU B, DU LY, MA YJ, et al. Effects of different combinations of artificial liver support system on efficacy and inflammatory indexes of patients with hepatitis B virus-related acute-on-chronic liver failure in early and middle stages[J/CD]. Chin J Liver Dis(Electr Version), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006. 吴蓓, 杜凌遥, 马元吉, 等. 不同组合人工肝支持系统治疗乙型肝炎病毒相关早、中期慢加急性肝衰竭患者的疗效及对炎症指标的影响[J/CD]. 中国肝脏病杂志(电子版), 2021, 13(1): 32-38. DOI: 10.3969/j.issn.1674-7380.2021.01.006.
[28]	GUO X, WU F, GUO W, et al. Comparison of plasma exchange, double plasma molecular adsorption system, and their combination in treating acute-on-chronic liver failure[J]. J Int Med Res, 2020, 48(6): 300060520932053. DOI: 10.1177/0300060520932053.
[29]	MAIWALL R, BAJPAI M, CHOUDHURY AK, et al. Therapeutic plasma-exchange improves systemic inflammation and survival in acute-on-chronic liver failure: A propensity-score matched study from AARC[J]. Liver Int, 2021, 41(5): 1083-1096. DOI: 10.1111/liv.14806.
[30]	SUNDARAM V, JALAN R, WU T, et al. Factors associated with survival of patients with severe acute-on-chronic liver failure before and after liver transplantation[J]. Gastroenterology, 2019, 156(5): 1381-1391. e3. DOI: 10.1053/j.gastro.2018.12.007.
[31]	KHANAM A, TREHANPATI N, RIESE P, et al. Blockade of neutrophil's chemokine receptors CXCR1/2 abrogate liver damage in acute-on-chronic liver failure[J]. Front Immunol, 2017, 8: 464. DOI: 10.3389/fimmu.2017.00464.
[32]	ANAND L, BIHARI C, KEDARISETTY CK, et al. Early cirrhosis and a preserved bone marrow niche favour regenerative response to growth factors in decompensated cirrhosis[J]. Liver Int, 2019, 39(1): 115-126. DOI: 10.1111/liv.13923.
[33]	ENGELMANN C, MARTINO VD, KERBERT A, et al. The current status of granulocyte-colony stimulating factor to treatacute-on-chronic liver failure[J]. Semin Liver Dis, 2021, 41(3): 298-307. DOI: 10.1055/s-0041-1723034.
[34]	LIN BL, CHEN JF, QIU WH, et al. Allogeneic bone marrow-derived mesenchymal stromal cells for hepatitis B virus-related acute-on-chronic liver failure: A randomized controlled trial[J]. Hepatology, 2017, 66(1): 209-219. DOI: 10.1002/hep.29189.
[35]	AHMAD A, WALI AF, REHMAN MU, et al. Therapeutic potential of rhododendron arboreum polysaccharides in an animal model of lipopolysaccharide-inflicted oxidative stress and systemic inflammation[J]. Molecules, 2020, 25(24): 6045. DOI: 10.3390/molecules25246045.
[36]	WANG X, SUN M, YANG X, et al. Value of liver regeneration in predicting short-term prognosis for patients with hepatitis B-related acute-on-chronic liver failure[J]. Biomed Res Int, 2020, 2020(4): 1-7. DOI: 10.1155/2020/5062873.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (685) PDF downloads(84)

Research advances in the role of inflammatory response and related treatment strategies in acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.08.041

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Research advances in the role of inflammatory response and related treatment strategies in acute-on-chronic liver failure

DOI: 10.3969/j.issn.1001-5256.2022.08.041

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content