肝硬化
医学
肝衰竭
重症监护医学
胃肠病学
内科学
作者
Jonel Trebicka,Rubén Hernáez,Debbie L. Shawcross,Alexander L. Gerbes
出处
期刊:Gut
[BMJ]
日期:2024-03-25
卷期号:73 (6): 1015-1024
被引量:4
标识
DOI:10.1136/gutjnl-2023-330584
摘要
The progression of cirrhosis with clinically significant portal hypertension towards decompensated cirrhosis remains clinically challenging and the evolution towards acute-on-chronic liver failure (ACLF), with one or more extrahepatic organ failures, is associated with very high mortality. In the last decade, significant progress has been made in the understanding of the mechanisms leading to decompensation and ACLF. As portal hypertension advances, bacterial translocation across an impaired gut barrier culminates in endotoxaemia, systemic inflammation and cirrhosis-associated immune dysfunction (CAID). Gut-derived systemic inflammation and CAID have become the logical targets for innovative therapies that prevent hepatic decompensation episodes and the progression to ACLF.Furthermore, classification of disease and biomarker discovery to personalise care have advanced in the field. This review discusses progress in biomarker discovery and personalisation of treatment in decompensated cirrhosis and ACLF.
科研通智能强力驱动
Strongly Powered by AbleSci AI