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2014 ; 13
(ä): 1131-44
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Immune mediated liver failure
#MMPMID26417328
Wang X
; Ning Q
EXCLI J
2014[]; 13
(ä): 1131-44
PMID26417328
show ga
Liver failure is a clinical syndrome of various etiologies, manifesting as
jaundice, encephalopathy, coagulopathy and circulatory dysfunction, which result
in subsequent multiorgan failure. Clinically, liver failure is classified into
four categories: acute, subacute, acute-on-chronic and chronic liver failure.
Massive hepatocyte death is considered to be the core event in the development of
liver failure, which occurs when the extent of hepatocyte death is beyond the
liver regenerative capacity. Direct damage and immune-mediated liver injury are
two major factors involved in this process. Increasing evidence has suggested the
essential role of immune-mediated liver injury in the pathogenesis of liver
failure. Here, we review the evolved concepts concerning the mechanisms of
immune-mediated liver injury in liver failure from human and animal studies. Both
innate and adaptive immunity, especially the interaction of various immune cells
and molecules as well as death receptor signaling system are discussed. In
addition, we highlight the concept of "immune coagulation", which has been shown
to be related to the disease progression and liver injury exacerbation in HBV
related acute-on-chronic liver failure.