Evidence map›Paper›PMID 41321934›Full record

ArticleJHEP reports : innovation in hepatology2025

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

Adrià Juanola, Gabriel Mezzano, Elisa Pose, Maria J Moreta, Simone Incicco, Roberta Gagliardi, Stine Johansen, Nikolaj Torp, Mads Israelsen, Natalia Jiménez-Esquivel and 35 more

Abstract read
In one paragraph

Article in JHEP reports : innovation in hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors.

Adrià JuanolaLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Gabriel MezzanoCentro de Enfermedades Digestivas, Universidad de los Andes, Chile.
Elisa PoseLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Maria J MoretaLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Simone InciccoUnit of Internal Medicine and Hepatology, Department of Medicine - Dimed, University and Hospital of Padova, Padova, Italy.
Roberta GagliardiUnit of Internal Medicine and Hepatology, Department of Medicine - Dimed, University and Hospital of Padova, Padova, Italy.
Stine JohansenCentre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark.
Nikolaj TorpCentre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark.
Mads IsraelsenCentre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark.
Natalia Jiménez-EsquivelLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Joaquin Castillo-IturraLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Jordi RiberaInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Jordi Gratacós-GinèsLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Anna SoriaLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Andrés CárdenasGI & Liver Transplant Unit, Institut de Malalties Digestives i Metaboliques, Hospital Clinic, Barcelona, Spain.
Martina Pérez-GuaschLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Marta CerveraInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Ruth NadalInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Queralt HermsLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Marta TononUnit of Internal Medicine and Hepatology, Department of Medicine - Dimed, University and Hospital of Padova, Padova, Italy.
Torben HansenNovo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
Evelina StankevicNovo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
Yun HuangNovo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
Victor VargasCentro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Giacomo ZaccheriniDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Carlo AlessandriaDivision of Gastroenterology and Hepatology, A. O. U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
Frank E UschnerDepartment of Internal Medicine B, University Hospital Münster, Münster, Germany.
Ulrich BeuersDepartment of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands.
Claire FrancozService d'Hépatologie, AP-HP, Hôpital Beaujon, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, Clichy, France.
Rajeshwar P MookerjeeInstitute for Liver and Digestive Health, University College London, London, United Kingdom.
Wim LalemanDepartment of Internal Medicine B, University Hospital Münster, Münster, Germany.
Cristina SoléCentro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Rafael BañaresCentro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Berta CuyàsCentro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Xavi ArizaDigestive Diseases Unit, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain.
Mar CollInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Isabel GrauperaLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.
Núria FabrellasInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Manuel Morales-RuizInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain.
Maja ThieleCentre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark.
Aleksander KragCentre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark.
Paolo AngeliUnit of Internal Medicine and Hepatology, Department of Medicine - Dimed, University and Hospital of Padova, Padova, Italy.
Salvatore PianoUnit of Internal Medicine and Hepatology, Department of Medicine - Dimed, University and Hospital of Padova, Padova, Italy.
Elsa SolàInstitute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California, USA.
Pere GinèsLiver Unit, Hospital Clínic of Barcelona, Barcelona, Catalunya, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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: Patients who developed bacterial infections had higher median levels of sPD-L1 than those who did not (160 [IQR 116-221] 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 its association with clinical outcomes in patients with chronic liver disease. Our findings demonstrate that soluble PD-L1 levels increase with the progression of liver disease and they are independently associated with an increased risk of bacterial infection development and mortality. These results could help physicians identify high-risk individuals earlier and implement preventive strategies.

Indexed as

Bacterial infectionBiomarkersDecompensated cirrhosisLiver cirrhosisMortalityPD-L1

Identifiers

PMID41321934
PMCPMC12661442

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.