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RESEARCH PRODUCT
New clinical and pathophysiological perspectives defining the trajectory of cirrhosis
Vicente ArroyoJonel TrebickaRichard MoreauRajiv JalanGennaro D'amicoPaolo Angelisubject
Liver Cirrhosis0301 basic medicinemedicine.medical_specialtyVaricesCirrhosisSystemic inflammationImmune System Phenomena03 medical and health sciences0302 clinical medicineImmunopathologyAscitesmedicineAcute on chronic liver failureHumansDecompensationIntensive care medicineHepatic encephalopathyHepatic encephalopathyInflammationHepatologybusiness.industryResearchOrgan dysfunctionGastroenterologyAscitesAcute on chronic liver failure; Ascites; Cirrhosis; Hepatic encephalopathy; Infection; Inflammation; Varicesmedicine.disease030104 developmental biologyCirrhosisDisease ProgressionPortal hypertension030211 gastroenterology & hepatologymedicine.symptombusinessInfectiondescription
Traditionally, the complications of cirrhosis, namely variceal bleeding, ascites and hepatic encephalopathy, were thought to result predominantly from circulatory dysfunction and altered organ perfusion arising as a result of portal hypertension. Over the past 20 years, large, international prospective studies have indicated the importance of systemic inflammation and organ immunopathology as additional determinants of organ dysfunction in cirrhosis, which not only manifests in the liver, brain, circulation and the kidneys, but also the immune system, gut, muscles, adrenal glands, reproductive organs, heart and lungs. This review provides an overview of the traditional and emerging concepts around the initiation and maintenance of organ dysfunction in cirrhosis and proposes a new paradigm based upon a better understanding of acute decompensation of cirrhosis. The interaction between the traditional concepts and the emerging perspectives remains a matter of great interest and the basis for future research.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-07-01 |