Balazs Irina, Stadlbauer Vanessa
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.
Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
JHEP Rep. 2023 Aug 1;5(11):100871. doi: 10.1016/j.jhepr.2023.100871. eCollection 2023 Nov.
Neutrophils are the largest population of leucocytes and are among the first cells of the innate immune system to fight against intruding pathogens. In patients with cirrhosis, neutrophils exhibit altered functionality, including changes in phagocytic ability, bacterial killing, chemotaxis, degranulation, reactive oxygen species production and NET (neutrophil extracellular trap) formation. This results in their inability to mount an adequate antibacterial response and protect the individual from infection. Prognosis and survival in patients with cirrhosis are greatly influenced by the development of infectious complications. Multidrug-resistant bacterial infections in patients with cirrhosis are currently a growing problem worldwide; therefore, alternative methods for the prevention and treatment of bacterial infections in cirrhosis are urgently needed. The prevention and treatment of neutrophil dysfunction could be a potential way to protect patients from bacterial infections. However, the reasons for changes in neutrophil function in cirrhosis are still not completely understood, which limits the development of efficient therapeutic strategies. Both cellular and serum factors have been proposed to contribute to the functional impairment of neutrophils. Herein, we review the current knowledge on features and proposed causes of neutrophil dysfunction in cirrhosis, with a focus on current knowledge gaps and limitations, as well as opportunities for future investigations in this field.
中性粒细胞是白细胞中数量最多的群体，是先天性免疫系统中最早对抗入侵病原体的细胞之一。在肝硬化患者中，中性粒细胞表现出功能改变，包括吞噬能力、细菌杀伤、趋化性、脱颗粒、活性氧生成和中性粒细胞胞外陷阱（NET）形成的变化。这导致它们无法产生足够的抗菌反应并保护个体免受感染。肝硬化患者的预后和生存受到感染性并发症发展的极大影响。肝硬化患者的多重耐药细菌感染目前在全球范围内是一个日益严重的问题；因此，迫切需要预防和治疗肝硬化细菌感染的替代方法。预防和治疗中性粒细胞功能障碍可能是保护患者免受细菌感染的一种潜在方法。然而，肝硬化中中性粒细胞功能改变的原因仍未完全了解，这限制了有效治疗策略的发展。细胞和血清因素都被认为与中性粒细胞的功能损害有关。在此，我们综述了目前关于肝硬化中中性粒细胞功能障碍的特征和推测原因的知识，重点关注当前的知识空白和局限性，以及该领域未来研究的机会。
