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Improved survival ratios correlate with myeloid dendritic cell restoration in acute-on-chronic liver failure patients receiving methylprednisolone therapy

Cellular & Molecular Immunology volume 9, pages 417–422 (2012)Cite this article

Abstract

Acute-on-chronic liver failure (ACLF) is a severe life-threatening complication. Liver transplantation is the only available therapeutic option; however, several limitations have restricted its use in patients. The use of corticosteroids as an optional therapy for ACLF has received a great deal of interest. The rationale behind its use is the possible role of the immune system in initiating and perpetuating hepatic damage. In order to assess the relationship between myeloid dendritic cells (mDCs) and the efficacy of methylprednisolone (MP) treatment for hepatitis B virus (HBV)-associated ACLF patients, we recruited 30 HBV-associated ACLF patients who had received MP treatment at 10-day intervals; 26 patients received conservative medical (CM) management as a control. The functionality of DC subsets was lower in these ACLF patients compared with healthy subjects. In addition, compared with survivors, dead/transplanted patients had lower functional mDC in both groups. Furthermore, a decreased numbers of mDC at baseline was associated with high mortality of ACLF patients. Importantly, MP treatment resulted in a significant decrease in 28-day mortality, and all MP patients exhibited an initial rapid decrease in circulating mDC numbers within 10 days of MP treatment. Subsequently, MP survivors displayed a continuous increase in mDC numbers accompanied by a decrease in total bilirubin levels by more than 30%. However, MP dead/transplanted patients lacked these sequential responses compared with survivors. This evidence suggests strongly that the higher mDC numbers at baseline and the recovery of mDC number at the end of treatment may represent a prognostic marker for favorable response to corticosteroid treatment in ACLF patients.

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Acknowledgements

This study is supported by the National Natural Science Foundation of China (Nos. 30801039 and 81072424) and the major projects of viral hepatitis from Beijing Municipal Science and Technology Commission (No. H020920020890). We thank the volunteers who generously participated in this study.

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Author notes

  1. Juan Zhao and Ji-Yuan Zhang: Juan Zhao and Ji-Yuan Zhang contributed equally to this work.

  2. Dr Q-H Meng, Department of Hepatology, Beijing You An Hospital, Capital Medical University, Beijing 100069, China. E-mail: meng_qh@sohu.com

  3. Dr F-S Wang, Research Center for Biological Therapy, the Institute of Translational Hepatology, Beijing 302 Hospital, Beijing 100039, China. E-mail: fswang@public.bta.net.cn

Authors and Affiliations

  1. Department of Hepatology, Beijing You An Hospital, Capital Medical University, Beijing, China

    Juan Zhao, Hong-Wei Yu, Yu-Lan He, Jing-Jing Zhao, Juan Li, Yue-Ke Zhu, Qin-Wei Yao, Jin-Huan Wang, Hai-Xia Liu, Shu-Yun Shi & Qing-Hua Meng

  2. Research Center for Biological Therapy, The Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, China

    Ji-Yuan Zhang, Xiang-Sheng Xu, Chun-Bao Zhou & Fu-Sheng Wang

  3. Department of Infectious Disease, Beijing 302 Hospital, Beijing, China

    Zheng-Sheng Zou

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Zhao, J., Zhang, JY., Yu, HW. et al. Improved survival ratios correlate with myeloid dendritic cell restoration in acute-on-chronic liver failure patients receiving methylprednisolone therapy. Cell Mol Immunol 9, 417–422 (2012). https://doi.org/10.1038/cmi.2011.51

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