ReviewJournal of hepatology2014
Cirrhosis-associated immune dysfunction: distinctive features and clinical relevance.
Review in Journal of hepatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 637 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
637 citing papers in PubMed, 3 syntheses or guidelines pooled it, 1,190 citations in OpenAlex.
- The Efficacy of Gut Microbiome-Modulating Therapies on Liver Cirrhosis: A Systematic Review and Network Meta-Analysis.Clinical and translational gastroenterology · 2026Pooled it
- Sodium-Glucose Cotransporter-2 Inhibitors in Liver Cirrhosis: A Systematic Review of Their Role in Ascites Management, Slowing Disease Progression, and Safety.International journal of molecular sciences · 2025Pooled it
- Predictive value of neutrophil to lymphocyte ratio for clinical outcomes in liver cirrhosis: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Platelet activation and short-term rifaximin therapy in decompensated cirrhosis: a pilot randomized controlled study.Internal and emergency medicine · 2026Trial
- Bacterial Infections in Patients With Severe Alcohol-Associated Hepatitis: Drivers of Organ Failure and Mortality.Liver international : official journal of the International Association for the Study of the Liver · 2025Trial
- A randomized study of ceftriaxone for the prevention of infections in hospitalized patients with advanced cirrhosis.Hepatology communications · 2024Trial
- Review article: Immunosuppression in Decompensated Autoimmune Hepatitis Cirrhosis - To Suppress or Not to Suppress?Alimentary pharmacology & therapeutics · 2026Review
- Temporal trends and demographic disparities in mortality with co-mention of chronic liver disease and pneumonia in the United States, 1999-2024.BMC gastroenterology · 2026Article
- Incidence and Mortality of Community-Acquired Sepsis or Bacteraemia in Patients With Alcohol-Related Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Review
- Risk Factors for Secondary Immunodeficiency in the Aged.The journal of allergy and clinical immunology. In practice · 2026Review
- Uncovering immune dysfunction in ACLF: Cellular mechanisms, molecular pathways, and therapeutic frontiers.Journal of hepatology · 2026Review
- Beyond Biochemical Clearance: Linking Immunosuppressive Bile-Acid Removal to Host Defense and Clinical Outcomes in Severe Liver Failure.Critical care explorations · 2026Article
- Gut Microbiota, Immunity, and Metabolism in the Progression From Chronic Liver Disease to Hepatocellular Carcinoma.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Spatial architecture of tertiary lymphoid structures represents an independent prognostic dimension in hepatocellular carcinoma.Journal for immunotherapy of cancer · 2026Article
- A 31-Year-Old Woman With Liver Cirrhosis Due to Wilson Disease and the Double Impact of Active Tuberculosis and Anti-Tuberculosis Therapy Resulting in Acute Liver Injury.The American journal of case reports · 2026Article
- Acute HEV Infection Is a Relevant Cause of Decompensation and ACLF in Patients With Liver Cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2026Observational
- Impact of cirrhosis on patients admitted with an exacerbation of acute chronic obstructive pulmonary disease: a nationwide analysis.Proceedings (Baylor University. Medical Center) · 2026Article
- Cholangiocyte biology in primary sclerosing cholangitis and other cholangiopathies: pathogenesis, clinical insights, and experimental tools.Physiological reviews · 2026Review
- The Regeneration Paradox in Liver Cancer: How Chronic Injury Transforms Healing into Carcinogenesis.Liver cancer · 2026Review
577 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The term cirrhosis-associated immune dysfunction refers to the main syndromic abnormalities of immune function, immunodeficiency and systemic inflammation that are present in cirrhosis. The course of advanced cirrhosis, regardless of its aetiology, is complicated by cirrhosis-associated immune dysfunction and this constitutes the pathophysiological hallmark of an increased susceptibility to bacterial infection, distinctive of the disease. Cirrhosis impairs the homeostatic role of the liver in the systemic immune response. Damage to the reticulo-endothelial system compromises the immune surveillance function of the organ and the reduced hepatic synthesis of proteins, involved in innate immunity and pattern recognition, hinders the bactericidal ability of phagocytic cells. Systemic inflammation, in form of activated circulating immune cells and increased serum levels of pro-inflammatory cytokines, is the result of persistent episodic activation of circulating immune cells from damage-associated molecular patterns, released from necrotic liver cells and, as cirrhosis progresses, from pathogen-associated molecular patterns, released from the leaky gut. Cirrhosis-associated immune dysfunction phenotypes switch from predominantly "pro-inflammatory" to predominantly "immunodeficient" in patients with stable ascitic cirrhosis and in patients with severely decompensated cirrhosis and extra-hepatic organ failure (e.g. acute-on-chronic liver failure), respectively. These cirrhosis-associated immune dysfunction phenotypes represent the extremes of a spectrum of reversible dynamic events that take place during the course of cirrhosis. Systemic inflammation can affect the functions of tissue somatic cells and modify the clinical manifestation of cirrhosis. The best characterized example is the contribution of systemic inflammation to the haemodynamic derangement of cirrhosis, which correlates negatively with prognosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.