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    Abnormal Innate Immunity in Acute-on-Chronic Liver Failure: Immunotargets for Therapeutics

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    Author
    Khanam, Arshi
    Kottilil, Shyam
    Date
    2020-10-08
    Journal
    Frontiers in Immunology
    Publisher
    Frontiers Media S.A.
    Type
    Article
    Other
    
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    Show full item record
    See at
    https://doi.org/10.3389/fimmu.2020.02013
    Abstract
    Acute-on-chronic liver failure (ACLF) is a severe life-threatening condition with high risk of multiorgan failure, sepsis, and mortality. ACLF activates a multifaceted interplay of both innate and adaptive immune response in the host which governs the overall outcome. Innate immune cells recognize the conserved elements of microbial and viral origin, both to extort instant defense by transforming into diverse modules of effector responses and to generate long-lasting immunity but can also trigger a massive intrahepatic immune inflammatory response. Acute insult results in the activation of innate immune cells which provokes cytokine and chemokine cascade and subsequently initiates aggressive systemic inflammatory response syndrome, hepatic damage, and high mortality in ACLF. Dysregulated innate immune response not only plays a critical role in disease progression but also potentially correlates with clinical disease severity indices including Child-Turcotte-Pugh, a model for end-stage liver disease, and sequential organ failure assessment score. A better understanding of the pathophysiological basis of the disease and precise immune mechanisms associated with liver injury offers a novel approach for the development of new and efficient therapies to treat this severely ill entity. Immunotherapies could be helpful in targeting immune-mediated organ damage which may constrain progression toward liver failure and eventually reduce the requirement for liver transplantation. Here, in this review we discuss the defects of different innate immune cells in ACLF which updates the current knowledge of innate immune response and provide potential targets for new therapeutic interventions. © Copyright © 2020 Khanam and Kottilil.
    Rights/Terms
    Copyright © 2020 Khanam and Kottilil.
    Keyword
    acute-on-chronic liver failure
    cytokines
    immune targets
    innate immune cells
    liver damage
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13995
    ae974a485f413a2113503eed53cd6c53
    10.3389/fimmu.2020.02013
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    UMB Open Access Articles 2020

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