The Role of the Liver in Sepsis

被引:471
作者
Yan, Jun [1 ,2 ]
Li, Song [3 ]
Li, Shulin [2 ]
机构
[1] Tongji Univ, Shanghai Peoples Hosp 10, Sch Med, Dept Musculoskeletal Oncol, Shanghai 200092, Peoples R China
[2] Univ Texas MD Anderson Canc Ctr, Dept Paediat Res, Houston, TX 77030 USA
[3] Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA
关键词
bacterial clearance; immunosuppression; inflammation; liver failure; liver injury; sepsis; SINUSOIDAL ENDOTHELIAL-CELLS; BACTERIAL CLEARANCE; HEPATIC-DYSFUNCTION; ORGAN DYSFUNCTION; KUPFFER CELLS; UNITED-STATES; T-CELLS; EPIDEMIOLOGY; DAMAGE; INFLAMMATION;
D O I
10.3109/08830185.2014.889129
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Despite the progress made in the clinical management of sepsis, sepsis morbidity and mortality rates remain high. The inflammatory pathogenesis and organ injury leading to death from sepsis are not fully understood for vital organs, especially the liver. Only recently has the role of the liver in sepsis begun to be revealed. Pre-existing liver dysfunction is a risk factor for the progression of infection to sepsis. Liver dysfunction after sepsis is an independent risk factor for multiple organ dysfunction and sepsis-induced death. The liver works as a lymphoid organ in response to sepsis. Acting as a double-edged sword in sepsis, the liver-mediated immune response is responsible for clearing bacteria and toxins but also causes inflammation, immunosuppression, and organ damage. Attenuating liver injury and restoring liver function lowers morbidity and mortality rates in patients with sepsis. This review summarizes the central role of liver in the host immune response to sepsis and in clinical outcomes.
引用
收藏
页码:498 / 510
页数:13
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