Role Of Cytokines In The Pathophysiology Of Acute On Chronic Liver Failure And The Effect Of Artificial Liver Support System Treatment

Acute-on-chronic liver failure is the commonest type of liver failure inour country, it has Rapid progression and high mortality. Though thepathogenesis of ACLF is unclear yet, in some representative hypothesis like“Double damage”,“Three attacks” and “Sepsis-like immune paralysis”，cytokines are all playing an important role, and the mechanism is verycomplex; Cytokines’ imbalance is the key factor mediated inacute-on-chronic liver failure. Because of the tissue-damaging mechanismsof cytokines are closely related to their hepatocyte proliferation and liverregeneration function, these cytokines simultaneously activate bothsurvival and apoptotic pathways and it depends on the level of pro-andantiapoptotic activities whether the balance will tip to one side or the other.So, it remains a challenge to selectively prevent the detrimental effects.Artificial liver support system is an extracorporeal device which can replace the partial functions of the normal liver. It is widely used in thetreatment of various severe liver disease, and has achieved good clinicalresults. Currently most studies show that artificial liver support system caneffectively remove excess pro-inflammatory cytokines and regulatecytokines’ balance. ALSS can block or ameliarate the variouspathophysiological processes mediated by these cytokines, improves thepatients’ clinical symptoms and indicators significantly. Therefore, depthstudy in role of cytokines in the pathophysiology of acute-on-chronic liverfailure and the effect of artificial liver support system treatment is helpfulin clinical work. In this paper we reviewed role of cytokines in thepathophysiology of acute-on-chronic liver failure and the effect of artificialliver support system treatment in recent years...