PD-L1 and the risk of bacterial infection in patients with chronic liver diseases: An international multicohort study

作者：Adrià Juanola, Gabriel Mezzano, Elisa Pose, Maria José Moreta, Simone Incicco, Roberta Gagliardi, Stine Johansen, Nikolaj Torp, Mads Egerod Israelsen, Natalia Jiménez, Joaquin Castillo-Iturra, Jordi Vayreda Ribera, Jordi Gratacós‐Ginès, Anna Sòria, Andrés Cárdenas, Martina Pérez-Guasch, Marta Alamar Cervera, Ruth Nadal, Queralt Herms, Marta Tonon, Torben F. Hansen, Evelina Stankevič, Yun Huang, Victor Vargas, Giacomo Zaccherini, Carlo Alessandria, Frank Erhard Uschner, Ulrich H. Beuers, Claire Francoz, Rajeshwar P. Mookerjee, Wim Laleman, Cristina Ros I Solé, Rafael Bañares, Berta Cuyàs, Xavier Ariza, Mar Coll, Isabel Graupera, Núria Fabrellas, Manuel Morales‐Ruiz, Maja Sofie Thiele, Aleksander Ahm Krag, Paolo Angeli, Salvatore Silvio Piano, Elsa Solà, Pere Ginès · 发表于：JHEP Reports · 年份：2025 · DOI：10.1016/j.jhepr.2025.101597 · 研究领域：Gut microbiota and health、Liver Diseases and Immunity、Liver Disease and Transplantation

Background & Aims: Impaired phagocytic capacity due to activation of the PD-1/PD-L1 pathway has been implicated in the development of bacterial infections in patients with cirrhosis. Soluble PD-L1 (sPD-L1) is easily measurable in plasma and has been proposed as a biomarker of sepsis. In the current study, we aim to evaluate the role of sPD-L1 as a biomarker of bacterial infection development in patients with cirrhosis. Methods: Plasma samples from 995 patients with chronic liver disease grouped in three cohorts were analyzed: an initial cohort of 268 hospitalized patients with acute decompensated cirrhosis, 327 out-patients with non-acute decompensated cirrhosis and finally 400 patients with high-risk alcohol consumption, including all stages of liver fibrosis, from mild/no fibrosis to cirrhosis (F0-F4). The main outcomes of the study were development of bacterial infection and mortality. Results: value <0.001; HR 1.066, 95% CI 1.043-1.089). These findings were observed in all cohorts. Conclusions: Plasma levels of sPD-L1 are associated with the risk of bacterial infection development irrespective of the stage of chronic liver disease. Furthermore, higher sPD-L1 levels are linked to increased mortality. Measurement of sPD-L1 levels may help identify patients at high risk of developing bacterial infections and guide the implementation of new preventive strategies. Impact and implications: This study explores the role of soluble PD-L1 as a biomarker of immune dysfunction and it...