Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough
ACLF is a specific, but complex and multifactorial form of acute decompensation of cirrhosis and is characterized by an extraordinary dynamic natural course, rapidly evolving organ failure, and high short-term mortality. Dysbalanced immune function is central to its pathogenesis and outcome with an...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/1027152 |
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| author | Wim Laleman Joan Claria Schalk Van der Merwe Richard Moreau Jonel Trebicka |
| author_facet | Wim Laleman Joan Claria Schalk Van der Merwe Richard Moreau Jonel Trebicka |
| author_sort | Wim Laleman |
| collection | DOAJ |
| description | ACLF is a specific, but complex and multifactorial form of acute decompensation of cirrhosis and is characterized by an extraordinary dynamic natural course, rapidly evolving organ failure, and high short-term mortality. Dysbalanced immune function is central to its pathogenesis and outcome with an initial excessive systemic inflammatory response that drives organ failure and mortality. Later in its course, immuno-exhaustion/immunoparalysis prevails predisposing the patient to secondary infectious events and reescalation in end-organ dysfunction and mortality. The management of patients with ACLF is still poorly defined. However, as its pathophysiology is gradually being unravelled, potential therapeutic targets emerge that warrant further study such as restoring or substituting albumin via plasma exchange or via albumin dialysis and evaluating usefulness of TLR4 antagonists, modulators of gut dysbiosis (pre- or probiotics), and FXR-agonists. |
| format | Article |
| id | doaj-art-bea7b476a21a4ae7a4242b2578e35d40 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-bea7b476a21a4ae7a4242b2578e35d402025-02-03T06:01:06ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/10271521027152Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not EnoughWim Laleman0Joan Claria1Schalk Van der Merwe2Richard Moreau3Jonel Trebicka4Department of Gastroenterology & Hepatology, Liver and Biliopancreatic Section, University Hospital Gasthuisberg, K.U. Leuven, Leuven, BelgiumEuropean Foundation for the Study of Chronic Liver Failure, Barcelona, SpainDepartment of Gastroenterology & Hepatology, Liver and Biliopancreatic Section, University Hospital Gasthuisberg, K.U. Leuven, Leuven, BelgiumEuropean Foundation for the Study of Chronic Liver Failure, Barcelona, SpainEuropean Foundation for the Study of Chronic Liver Failure, Barcelona, SpainACLF is a specific, but complex and multifactorial form of acute decompensation of cirrhosis and is characterized by an extraordinary dynamic natural course, rapidly evolving organ failure, and high short-term mortality. Dysbalanced immune function is central to its pathogenesis and outcome with an initial excessive systemic inflammatory response that drives organ failure and mortality. Later in its course, immuno-exhaustion/immunoparalysis prevails predisposing the patient to secondary infectious events and reescalation in end-organ dysfunction and mortality. The management of patients with ACLF is still poorly defined. However, as its pathophysiology is gradually being unravelled, potential therapeutic targets emerge that warrant further study such as restoring or substituting albumin via plasma exchange or via albumin dialysis and evaluating usefulness of TLR4 antagonists, modulators of gut dysbiosis (pre- or probiotics), and FXR-agonists.http://dx.doi.org/10.1155/2018/1027152 |
| spellingShingle | Wim Laleman Joan Claria Schalk Van der Merwe Richard Moreau Jonel Trebicka Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough Canadian Journal of Gastroenterology and Hepatology |
| title | Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough |
| title_full | Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough |
| title_fullStr | Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough |
| title_full_unstemmed | Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough |
| title_short | Systemic Inflammation and Acute-on-Chronic Liver Failure: Too Much, Not Enough |
| title_sort | systemic inflammation and acute on chronic liver failure too much not enough |
| url | http://dx.doi.org/10.1155/2018/1027152 |
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