Patient Plasma‐Induced Neutrophil Dysfunction Is Associated With Infection Risk and Mortality in Patients With Acute Decompensation of Cirrhosis

作者：Supachaya Sriphoosanaphan, Jane Macnaughtan, Haw Lu, Rohit Sawhney, Qianwen Zhao, Su Lin, Rocío Gallego‐Durán, Emmanuel Wey, Nathan Davies, Rajeshwar P. Mookerjee, Rajiv Jalan · 发表于：Alimentary Pharmacology & Therapeutics · 年份：2025 · DOI：10.1111/apt.70480 · 被引用次数：2 · 研究领域：Liver Disease and Transplantation、Sepsis Diagnosis and Treatment、Immune Response and Inflammation

BACKGROUND AND AIMS: Bacterial infection is a major cause of morbidity and mortality in patients with acute decompensation (AD) of cirrhosis. This study aimed to investigate patient plasma-induced dysfunction of healthy neutrophils (PIND) as a predictor of subsequent infection and mortality in patients with AD. METHODS: One hundred sixty AD patients (117 AD-NoACLF and 43 AD-ACLF), with a predominantly alcohol-related liver disease, were prospectively recruited. Plasma from 21 healthy controls and 74 patients with stable compensated cirrhosis was used as controls. Patient plasma was co-incubated with neutrophils from healthy donors to assess neutrophil function, including reactive oxygen species (ROS) production and phagocytic capacity, and CD62L surface expression. RESULTS: Plasma from AD patients induced a primed state in healthy neutrophils, characterised by increased constitutive and N-formyl-Met-Leu-Phe (fMLP)-induced ROS production. However, effector functions were impaired, with significantly reduced phorbol 12-myristate 13-acetate (PMA)-induced ROS production, phagocytic capacity and CD62L expression. Escherichia coli- induced ROS production predicted subsequent infection in the total AD and AD-NoACLF cohorts (p = 0.043 and p = 0.013, respectively), while PMA-induced ROS production predicted 90-day mortality in the AD-NoACLF group (p = 0.041). None of the neutrophil function assays were predictive of clinical outcomes in AD-ACLF patients. CONCLUSIONS: Plasma from patie...