Laboratory of Molecular Immunology, Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences New Delhi, India.
Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
Clin Immunol. 2021 Oct;231:108829. doi: 10.1016/j.clim.2021.108829. Epub 2021 Aug 20.
Massive cellular necrosis in acute liver failure (ALF) is dominantly immune mediated and innate immune cells are major pathophysiological determinants in liver damage. In fifty ALF and fifteen healthy, immune cells phenotyping by flow-cytometry, DAMPs using ELISA were analysed and correlated with clinical and biochemical parameters. ALF patients (aged 27 ± 9 yr, 56% males, 78% viral aetiology) showed no difference in neutrophils and classical monocytes, but significantly increased intermediate monocytes (CD14CD16) (p < 0.01), decreased non-classical monocytes (CD14CD16) and CD3CD16CD56 NK cells compared to HC. ALF patients who survived, showed higher NK cells (9.28 vs. 5.1%, p < 0.001) among lymphocytes and lower serum lactate levels (6.1 vs. 28, Odds ratio 2.23, CI 1.27-3.94) than non- survivors had higher. Logistic regression model predicted the combination of lactate levels with NK cell percentage at admission for survival. In conclusion, Combination of NK cell frequency among lymphocytes and lactate levels at admission can reliably predict survival of ALF patients.
急性肝衰竭 (ALF) 中大量的细胞坏死主要是免疫介导的，固有免疫细胞是肝损伤的主要病理生理决定因素。本研究通过流式细胞术对 50 名 ALF 患者和 15 名健康对照者的免疫细胞进行表型分析，采用 ELISA 法检测 DAMPs，并与临床和生化参数相关分析。ALF 患者（年龄 27±9 岁，56%为男性，78%为病毒性病因）中性粒细胞和经典单核细胞无差异，但中间单核细胞（CD14CD16）明显增加（p<0.01），非经典单核细胞（CD14CD16）和 CD3CD16CD56 NK 细胞减少。与对照组相比，存活的 ALF 患者淋巴细胞中 NK 细胞（9.28% vs. 5.1%，p<0.001）更高，血清乳酸水平（6.1 vs. 28，比值比 2.23，95%置信区间 1.27-3.94）更低。Logistic 回归模型预测入院时乳酸水平与 NK 细胞百分比的联合对生存的预测作用。结论：淋巴细胞中 NK 细胞频率与入院时乳酸水平的联合可可靠地预测 ALF 患者的生存。
