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Plasma-Driven Monocyte Dysfunction Drives Disease Progression in Alcohol-Related Acute-on-Chronic Liver Failure.
B Vijayalekshmi1, Anita Chaudhary1, Savit B Prabhu1
1Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Journal of Gastroenterology and Hepatology
|August 3, 2025
Summary
Alcohol-related acute-on-chronic liver failure (A-ACLF) involves immune cell dysfunction and inflammation. Targeting plasma mediators may offer new treatments for this severe liver condition.
Area of Science:
- Hepatology
- Immunology
- Critical Care Medicine
Background:
- Acute-on-chronic liver failure (ACLF) is marked by immune dysregulation, with alcohol-related ACLF (A-ACLF) having high mortality.
- The specific roles of monocyte dysfunction and plasma inflammatory mediators in A-ACLF are not well understood.
Purpose of the Study:
- To investigate monocyte function and plasma immune markers in patients with A-ACLF.
- To explore the impact of A-ACLF plasma on healthy monocyte behavior and cytokine production.
Main Methods:
- Prospective study of A-ACLF patients and healthy controls.
- Monocyte phenotyping, serum immune marker analysis (sCD163, sCD25, ferritin, IgG complexes).
- Ex vivo plasma priming experiments on healthy monocytes to measure cytokine secretion.
Main Results:
- A-ACLF patients exhibited altered monocyte proportions and counts, correlating with MELD scores and poor outcomes.
- A-ACLF monocytes showed signs of hyperactivation (increased Fc receptor) and exhaustion (decreased HLA-DR), with increased liver-homing receptor CCR2.
- A-ACLF plasma induced monocyte differentiation changes and increased pro-inflammatory cytokine secretion (TNF-α, IL-1β, IL-12, G-CSF) in healthy monocytes.
Conclusions:
- Monocyte dysfunction and plasma-induced immune alterations are central to A-ACLF pathogenesis and prognosis.
- Plasma-derived inflammatory mediators represent potential therapeutic targets for A-ACLF.
Keywords:
acute‐on‐chronic liver failurealcoholic hepatitisimmune dysfunctioninflammationmonocyte activationsCD163More Related Videos
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