Role of intestinal barrier disruption to acute-on-chronic liver failure

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Item Type:	Review
Title:	Role of intestinal barrier disruption to acute-on-chronic liver failure
Creators Name:	Pohl, J., Aretakis, D., Tacke, F., Engelmann, C. and Sigal, M.
Abstract:	Acute-on-chronic liver failure (ACLF) is a severe condition in patients with decompensated liver cirrhosis, marked by high short-term mortality. Recent experimental and clinical evidence has linked intestinal dysfunction to both the initiation of ACLF as well as disease outcome. This review discusses the significant role of the gut-liver axis in ACLF pathogenesis, highlighting recent advances. Gut mucosal barrier disruption, gut dysbiosis, and bacterial translocation emerge as key factors contributing to systemic inflammation in ACLF. Different approaches of therapeutically targeting the gut-liver axis via farnesoid X receptor agonists, nonselective beta receptor blockers, antibiotics, and probiotics are discussed as potential strategies mitigating ACLF progression. The importance of understanding the distinct pathophysiology of ACLF compared with other stages of liver cirrhosis is highlighted. In conclusion, research findings suggest that disruption of intestinal integrity may be an integral component of ACLF pathogenesis, paving the way for novel diagnostic and therapeutic approaches to manage this syndrome more effectively.
Keywords:	Liver Cirrhosis, Acute-On-Chronic Liver Failure, Gut, Bacterial Translocation, Systemic Inflammation
Source:	Seminars in Liver Disease
ISSN:	1098-8971
Publisher:	Thieme
Date:	13 March 2025
Official Publication:	https://doi.org/10.1055/a-2516-2361
PubMed:	View item in PubMed

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