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Chronic Pancreatitis I: Introduction01:24

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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
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Cirrhosis-associated immune dysfunction.

Agustín Albillos1,2,3, Rosa Martin-Mateos4,5,6, Schalk Van der Merwe7,8

  • 1Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. agustin.albillos@uah.es.

Nature Reviews. Gastroenterology & Hepatology
|October 27, 2021
PubMed
Summary
This summary is machine-generated.

Cirrhosis-associated immune dysfunction (CAID) involves systemic inflammation and immune deficiency that worsens with liver disease progression. Two phenotypes exist: low-grade inflammation in compensated disease and high-grade inflammation with immune paralysis in severe liver failure.

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Area of Science:

  • Hepatology
  • Immunology
  • Internal Medicine

Background:

  • Cirrhosis-associated immune dysfunction (CAID) describes immune alterations in end-stage liver disease.
  • CAID is characterized by systemic inflammation and immune deficiency, worsening with disease progression.

Purpose of the Study:

  • To define the spectrum of immune alterations in cirrhosis.
  • To describe the two distinct immune phenotypes of CAID.
  • To highlight the clinical implications of CAID intensity.

Main Methods:

  • Review of existing literature on cirrhosis-associated immune dysfunction.
  • Classification of CAID into distinct phenotypes based on clinical presentation and immune status.

Main Results:

  • CAID presents as two phenotypes: low-grade systemic inflammation (compensated/decompensated cirrhosis without organ failure) and high-grade systemic inflammation with immune paralysis (acute-on-chronic liver failure).
  • The high-grade phenotype is associated with organ failure, increased infection risk, and mortality.
  • CAID intensity correlates with liver insufficiency, bacterial translocation, and organ failure.

Conclusions:

  • CAID is a dynamic process with distinct phenotypes influencing cirrhosis progression and patient outcomes.
  • Understanding CAID phenotypes is crucial for managing patients with advanced liver disease.
  • Therapeutic strategies targeting immune modulation are under investigation.