Liver - guardian, modifier and target of sepsis

被引:613
作者
Strnad, Pavel [1 ,2 ]
Tacke, Frank [1 ]
Koch, Alexander [1 ]
Trautwein, Christian [1 ]
机构
[1] Univ Hosp Aachen, Dept Internal Med 3, Pauwelsstr 30, D-52074 Aachen, Germany
[2] Univ Hosp Aachen, Interdisciplinary Ctr Clin Res, Pauwelsstr 30, D-52074 Aachen, Germany
关键词
SPONTANEOUS BACTERIAL PERITONITIS; SYSTEMIC INFLAMMATORY RESPONSE; NONSELECTIVE BETA-BLOCKERS; ACUTE-PHASE PROTEINS; CRITICALLY-ILL PATIENTS; HEPATORENAL-SYNDROME; SEPTIC SHOCK; CIRRHOTIC-PATIENTS; GENE-EXPRESSION; ORGAN FAILURE;
D O I
10.1038/nrgastro.2016.168
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Sepsis and septic shock are characterized by life-threatening organ dysfunction caused by a dysregulated host response to infection. The liver has a central role during sepsis, and is essential to the regulation of immune defence during systemic infections by mechanisms such as bacterial clearance, acute-phase protein or cytokine production and metabolic adaptation to inflammation. However, the liver is also a target for sepsis-related injury, including hypoxic hepatitis due to ischaemia and shock, cholestasis due to altered bile metabolism, hepatocellular injury due to drug toxicity or overwhelming inflammation, as well as distinct pathologies such as secondary sclerosing cholangitis in critically ill patients. Hence, hepatic dysfunction substantially impairs the prognosis of sepsis and serves as a powerful independent predictor of mortality in the intensive care unit. Sepsis is particularly problematic in patients with liver cirrhosis (who experience increased bacterial translocation from the gut and impaired microbial defence) as it can trigger acute-on-chronic liver failure a syndrome with high short-term mortality. Here, we review the importance of the liver as a guardian, modifier and target of sepsis, the factors that contribute to sepsis in patients with liver cirrhosis and new therapeutic strategies.
引用
收藏
页码:55 / 66
页数:12
相关论文
共 171 条
[1]
Scaling of immune responses against intracellular bacterial infection [J].
Abdullah, Zeinab ;
Knolle, Percy A. .
EMBO JOURNAL, 2014, 33 (20) :2283-2294
[2]
Sepsis-induced acute kidney injury in patients with cirrhosis [J].
Angeli, Paolo ;
Tonon, Marta ;
Pilutti, Chiara ;
Morando, Filippo ;
Piano, Salvatore .
HEPATOLOGY INTERNATIONAL, 2016, 10 (01) :115-123
[3]
Catecholamines induce an inflammatory response in human hepatocytes [J].
Aninat, Caroline ;
Seguin, Philippe ;
Descheemaeker, Pierre-Neri ;
Morel, Fabrice ;
Malledant, Yannick ;
Guillouzo, Andre .
CRITICAL CARE MEDICINE, 2008, 36 (03) :848-854
[4]
[Anonymous], GASTROENTEROLOGY
[5]
[Anonymous], HEPATOLOGY
[6]
[Anonymous], LIVER PHYSL
[7]
[Anonymous], J HEPATOL
[8]
Nucleotide-Binding Oligomerization Domain Containing 2 (NOD2) Variants Are Genetic Risk Factors for Death and Spontaneous Bacterial Peritonitis in Liver Cirrhosis [J].
Appenrodt, Beate ;
Gruenhage, Frank ;
Gentemann, Martin G. ;
Thyssen, Lydia ;
Sauerbruch, Tilman ;
Lammert, Frank .
HEPATOLOGY, 2010, 51 (04) :1327-1333
[9]
Antimicrobial Therapeutic Determinants of Outcomes From Septic Shock Among Patients With Cirrhosis [J].
Arabi, Yaseen M. ;
Dara, Saqib I. ;
Memish, Ziad ;
Al Abdulkareem, Abdulmajeed ;
Tamim, Hani M. ;
Al-Shirawi, Nehad ;
Parrillo, Joseph E. ;
Dodek, Peter ;
Lapinsky, Stephen ;
Feinstein, Daniel ;
Wood, Gordon ;
Dial, Sandra ;
Zanotti, Sergio ;
Kumar, Anand .
HEPATOLOGY, 2012, 56 (06) :2305-2315
[10]
Hepcidin-Induced Hypoferremia Is a Critical Host Defense Mechanism against the Siderophilic Bacterium Vibrio vulnificus [J].
Arezes, Joao ;
Jung, Grace ;
Gabayan, Victoria ;
Valore, Erika ;
Ruchala, Piotr ;
Gulig, Paul A. ;
Ganz, Tomas ;
Nemeth, Elizabeta ;
Bulut, Yonca .
CELL HOST & MICROBE, 2015, 17 (01) :47-57