Innate immune dysfunction in acute and chronic liver disease

被引：40

作者：

Leber, Bettina ^{[2
]}

Mayrhauser, Ursula ^{[2
]}

Rybczynski, Michael ^{[1
]}

Stadlbauer, Vanessa ^{[1
]}

机构：

[1] Med Univ Graz, Div Internal Med, A-8036 Graz, Austria

[2] Med Univ Graz, Div Surg, A-8036 Graz, Austria

来源：

WIENER KLINISCHE WOCHENSCHRIFT | 2009年 / 121卷 / 23-24期

关键词：

Cirrhosis; acute-on-chronic liver failure; acute liver failure; infection; endotoxin; immune dysfunction; neutrophil; monocyte; albumin; toll-like receptors; gut permeability; CRITICALLY-ILL PATIENTS; ANTIBIOTIC-ASSOCIATED DIARRHEA; SEVERE ALCOHOLIC HEPATITIS; ORGAN SYSTEM FAILURE; SHORT-TERM PROGNOSIS; TOLL-LIKE RECEPTORS; HUMAN SERUM-ALBUMIN; CIRRHOTIC-PATIENTS; BACTERIAL-INFECTIONS; NEUTROPHIL DYSFUNCTION;

D O I：

10.1007/s00508-009-1288-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Liver cirrhosis is a common disease causing great public-health concern because of the frequent complications requiring hospital care. Acute liver failure is also prone to several complications but is rare. One of the main complications for both acute and chronic liver diseases is infection, which regularly causes decompensation of cirrhosis, possibly leading to organ failure and death. This review focuses on innate immune function in cirrhosis, acute-on-chronic liver failure and acute liver failure. The known defects of Kupffer cells, neutrophils and monocytes are discussed, together with the pathophysiological importance of gut permeability, portal hypertension and intrinsic cellular defects, and the role of endotoxin, albumin, lipoproteins and toll-like receptors. Based on these different pathomechanisms, the available information on therapeutic strategies is presented. Antibiotic and probiotic treatment, nutritional support, artificial liver support, and experimental strategies such as inhibition of toll-like receptors and use of albumin and colony-stimulating factors are highlighted.

引用

页码：732 / 744

页数：13

共 150 条

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