Prognostic and therapeutic significance of microbial cell-free DNA in plasma of people with acute decompensation of cirrhosis

Prognostic value of virtual portal pressure gradient response in compensated cirrhotic patients treated with carvedilol

“…reported that the inhibition of hepatic inflammatory response could substantially attenuate CPH. Nonhemodynamic effects including anti‐inflammation of NSBBs had been reported in previous studies 13,17,19–21 . Data has further suggested a role of MCP‐1 mediated recruitment of monocytes in carvedilol's anti‐inflammatory effects 23,24 .…”

“…Nonhemodynamic effects including antiinflammation of NSBBs had been reported in previous studies. 13,17,[19][20][21] Data has further suggested a role of MCP-1 mediated recruitment of monocytes in carvedilol's antiinflammatory effects. 23,24 In the present study, all included patients had low-level systemic inflammation, as reflected by low concentrations of serum MCP-1 at baseline, which had been characterized to be an independent risk factor of ascites.…”

“…In patients with CC, carvedilol is the preferred NSBB as it has a tendency toward better tolerance than traditional NSBBs and has been reported to further HEPATOLOGY RESEARCH improve survival. [13][14][15][16] In addition, in patients with decompensated cirrhosis, carvedilol has been described to exert antifibrogenic, 17 antiangiogenic 18 and anti-inflammatory 13,17,[19][20][21][22][23] effects by decreasing MCP-1, a well-documented cytokine to enhance liver infiltration of monocytes. 24 However, there are a lot of unknowns about its long-term effects in CC.…”

“…In contrast with traditional NSBBs (i.e., propranolol and nadolol), the nonclassical NSBBs (i.e., carvedilol) have intrinsic anti‐alpha adrenergic vasodilatory effects that contribute to its greater PP reducing effects. In patients with CC, carvedilol is the preferred NSBB as it has a tendency toward better tolerance than traditional NSBBs and has been reported to further improve survival 13–16 . In addition, in patients with decompensated cirrhosis, carvedilol has been described to exert antifibrogenic, 17 antiangiogenic 18 and anti‐inflammatory 13,17,19–23 effects by decreasing MCP‐1, a well‐documented cytokine to enhance liver infiltration of monocytes 24 .…”

Pathophysiology and management of liver cirrhosis: from portal hypertension to acute-on-chronic liver failure

“…In ∼2-16% of the patients, no precipitant is identified (162). In this context, there has been recent interest in the identification of uncommon precipitants like cytomegalovirus as potential acute precipitants in ACLF in the background of a state of immune dysfunction in ACLF with CMV positivity in up to 24% of the cases (163). Similarly, drug-induced liver injury has been more frequently recognized with a large cohort of 3,132 patients with ACLF, having DILI as the precipitating event in 10.5% out of which the most common were complementary and alternative medications (71.7%) (164).…”