Abstract
Acute-on-chronic liver failure (Acute-on-chronic liver failure, ACLF) is acute liver function decompensation on the basis of chronic liver disease. The progression of ACLF develops from advanced phase, plateau phase to remission phase. The pathophysiological basis of ACLF in different phases is various. In advanced phase, immune imbalance and systemic inflammatory reaction plays key roles. In this study, we try to assess the association between expression of NK cells and its receptors and prognosis of patients with ACLF in advanced phase. A total of 35 inpatients with HBV acute-on-chronic liver failure in advanced phase were recruited. They were divided into case group (n = 18) and control group (n = 17) according to whether the patients was dead in the 12 weeks. PBMC were detected for the frequency and expression of NK cell receptors by flow cytometric analysis. Our results demonstrated that patients who died had lower expression of NK cells and inhibitory receptor KIR3DL1, higher levels of FASL. During 12-week follow-up in those case alive, we found that NK cells increased, while expression of FASL decreased. High short-term mortality of ALCF was associated with NK cell, especially related to KIR3DL1 and FASL (PNK = 0.036, PKIR3DL1 = 0.0265, PFasL = 0.0008).
Highlights
IntroductionAcute-on-chronic liver failure (ACLF) results in multiorgan failure and high
We try to assess the association between expression of NK cells and its receptors and prognosis of patients with Acute-on-chronic liver failure (ACLF) in advanced phase
Our results demonstrated that patients who died of liver failure in advanced phase had lower expression of NK cell and inhibitory receptor KIR3DL1, while higher levels of FASL were observed
Summary
Acute-on-chronic liver failure (ACLF) results in multiorgan failure and high. In China, the most common cause for liver failure is hepatitis B virus infection. The progression of ACLF can be divided into several stages: advanced phase, plateau phase and remission phase. Patients undergo various pathophysiology [2]. No criteria are available for the precise definition of different phases. According to whether their total bilirubin within 7 days of average daily rise is ≥17.1 umol/L or not, we differentiated patients with ACLF into advanced phase and not-advanced phase
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