The Molecular Basis of Susceptibility to Infection in Liver Cirrhosis

Abstract

There is much clinical evidence of a relationship between infectious disease and chronic liver disease. The consequences of this adverse association have been described and advances in the treatment and prophylaxis of infectious disease have had an important effect on the management of patients with chronic liver disease. The association between infectious disease and chronic liver disease involves altered cytokine production, cellular immunity, and vascular response. However, there is little information on the mechanisms underlying these phenomena. In this report, we review the mechanistic basis of this common association.

Extensive chronic xanthogranulomatous intra-abdominal inflammation due to Mycoplasma hominis mimicking a malignancy: a case report

“…Although speculative, we consider this patient's liver cirrhosis was a contributing factor in the development of this extensive infectious complication. Susceptibility to infection in liver cirrhosis may be due to multiple factors, such as cytokine dysfunction altering the inflammatory response, impaired cellular immunity and hemodynamic dysfunction with systemic vasodilatation [15]. …”

Impact of pretransplant infections on clinical outcomes of liver transplant recipients

“…Nevertheless, patients with liver cirrhosis prior to transplantation remain vulnerable to bacterial infections and have a higher risk of dying from sepsis 3. The increased susceptibility to infections in patients with cirrhosis is primarily due to immune dysfunction, which includes decreased bactericidal activity of phagocytic cells, complement level deficiency, impairment of the reticuloendothelial system, altered inflammatory responses, and hemodynamic dysfunction 4, 5. The most common infection in this population is spontaneous bacterial peritonitis (SBP), and this is followed by urinary tract infections and pneumonia 6…”

Bacterial Meningitis in Cirrhotic Patients

“…The Child-Pugh-Turcotte score at admission was 10 (range: [6][7][8][9][10][11][12][13][14] and at the outcome was 11 (range: 7-15). Five patients died (42%): 4 during hospitalization (range: 2-14 days) and 1 after being discharged from the hospital (70 days).…”

“…6 Perney et al 7 showed that alcoholic patients have altered immunity because of the function of natural killer cells and diminished expression of perforin. Moreover, the activity of peripheral mononuclear cells induced by interleukin-2 and the production of interferons are diminished.…”