Invasive fungal infection before and after liver transplantation

Ferrarese, Alberto; Cattelan, Annamaria; Cillo, U.; Gringeri, Enrico; Russo, Francesco Paolo; Germani, Giacomo; Gambato, Martina; Burra, Patrizia; Senzolo, Marco

doi:10.3748/wjg.v26.i47.7485

Cited by 32 publications

(30 citation statements)

References 66 publications

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“…A study reported the occurrence of invasive fungal disease in 43% of patients with ACLF and observed higher mortality in these patients than those without the invasive fungal disease ( 107 ). Candida as well as Aspergillus species are the common infections in ACLF and primarily infect urinary and respiratory tracts ( 108 , 109 ). Like a bacterial infection, a fungal infection could act as the main precipitating event in ACLF; however, the mechanism is not well-recognized.…”

Section: Complications In Aclfmentioning

confidence: 99%

Acute-on-Chronic Liver Failure: Pathophysiological Mechanisms and Management

Khanam

Kottilil

2021

Front. Med.

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Acute-on-chronic liver failure (ACLF) is a multifaceted condition with poor treatment options and high short-term mortality. ACLF can develop in patients with or without liver cirrhosis, where patients with decompensated cirrhosis display a higher risk of short-term mortality. Pathophysiological mechanisms include systemic inflammation due to bacterial and fungal infections and acute hepatic insult with drug, alcohol, and viral hepatitis. Cryptogenic factors also contribute to the development of ACLF. The clinical outcome of patients with ACLF gets further complicated by the occurrence of variceal hemorrhage, hepatorenal syndrome, hepatic encephalopathy, and systemic immune dysfunction. Regardless of the better understanding of pathophysiological mechanisms, no specific and definitive treatment is available except for liver transplantation. The recent approach of regenerative medicine using mesenchymal stem cells (MSCs) could be advantageous for the treatment of ACLF as these cells can downregulate inflammatory response by inducing antiinflammatory events and prevent hepatic damage and fibrosis by inhibiting hepatic stellate cell activation and collagen synthesis. Moreover, MSCs are involved in tissue repair by the process of liver regeneration. Considering the broad therapeutic potential of MSCs, it can serve as an alternative treatment to liver transplant in the near future, if promising results are achieved.

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Section: Complications In Aclfmentioning

confidence: 99%

Acute-on-Chronic Liver Failure: Pathophysiological Mechanisms and Management

Khanam

Kottilil

2021

Front. Med.

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“…Furthermore, the gut concentration of TCA is considerably altered in different diseases. Specifically, TCA is highly up-regulated in immunocompromised cancer patients [30][31][32], drug-induced liver injury [33][34][35], high-fat diets [36], and liver cirrhosis [37][38][39][40][41][42], conditions that are associated with severe morbidity and mortality caused by CA. Numerous FDA-approved drugs and probiotics currently used to treat various diseases also profoundly alter bile acid levels, including TCA in the gut [43][44][45][46][47][48][49][50][51][52].…”

Section: Introductionmentioning

confidence: 99%

Bile Acid Regulates the Colonization and Dissemination of Candida albicans from the Gastrointestinal Tract by Controlling Host Defense System and Microbiota

Thangamani

Monasky

Lee

et al. 2021

JoF

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Candida albicans (CA), a commensal and opportunistic eukaryotic organism, frequently inhabits the gastrointestinal (GI) tract and causes life-threatening infections. Antibiotic-induced gut dysbiosis is a major risk factor for increased CA colonization and dissemination from the GI tract. We identified a significant increase of taurocholic acid (TCA), a major bile acid in antibiotic-treated mice susceptible to CA infection. In vivo findings indicate that administration of TCA through drinking water is sufficient to induce colonization and dissemination of CA in wild-type and immunosuppressed mice. Treatment with TCA significantly reduced mRNA expression of immune genes ang4 and Cxcr3 in the colon. In addition, TCA significantly decreased the relative abundance of three culturable species of commensal bacteria, Turicibacter sanguinis, Lactobacillus johnsonii, and Clostridium celatum, in both cecal contents and mucosal scrapings from the colon. Taken together, our results indicate that TCA promotes fungal colonization and dissemination of CA from the GI tract by controlling the host defense system and intestinal microbiota that play a critical role in regulating CA in the intestine.

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“…Other important remarks should be offered to the reader. First, this paper does not include prophylaxis against invasive fungal infection, which is another serious complication in cirrhosis, having an increasing prevalence and a dreadful outcome[ 92 ]. Second, although we have focused on systemic antibiotic prophylaxis, growing evidence on non-antibiotic prophylaxis against BI in cirrhosis has to be mentioned.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice

Ferrarese¹,

Passigato²,

Cusumano³

et al. 2021

WJH

Self Cite

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Patients with cirrhosis show an increased susceptibility to infection due to disease-related immune-dysfunction. Bacterial infection therefore represents a common, often detrimental event in patients with advanced liver disease, since it can worsen portal hypertension and impair the function of hepatic and extra-hepatic organs. Among pharmacological strategies to prevent infection, antibiotic prophylaxis remains the first-choice, especially in high-risk groups, such as patients with acute variceal bleeding, low ascitic fluid proteins, and prior episodes of spontaneous bacterial peritonitis. Nevertheless, antibiotic prophylaxis has to deal with the changing bacterial epidemiology in cirrhosis, with increased rates of gram-positive bacteria and multidrug resistant rods, warnings about quinolones-related side effects, and low prescription adherence. Short-term antibiotic prophylaxis is applied in many other settings during hospitalization, such as before interventional or surgical procedures, but often without knowledge of local bacterial epidemiology and without strict adherence to antimicrobial stewardship. This paper offers a detailed overview on the application of antibiotic prophylaxis in cirrhosis, according to the current evidence.

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Invasive fungal infection before and after liver transplantation

Cited by 32 publications

References 66 publications

Acute-on-Chronic Liver Failure: Pathophysiological Mechanisms and Management

Acute-on-Chronic Liver Failure: Pathophysiological Mechanisms and Management

Bile Acid Regulates the Colonization and Dissemination of Candida albicans from the Gastrointestinal Tract by Controlling Host Defense System and Microbiota

Antibiotic prophylaxis in patients with cirrhosis: Current evidence for clinical practice

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