Chen JW, Liu CY, Li S, Wu SW, Cai C, Lu MQ. Sepsis-associated liver injury: Mechanisms and potential therapeutic targets. World J Gastroenterol 2024; 30(42): 4518-4522 [PMID: 39563749 DOI: 10.3748/wjg.v30.i42.4518]
Corresponding Author of This Article
Ming-Qin Lu, Doctor, MD, Chief Physician, Professor, Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, No. 1 Fanhai West Road, Ouhai District, Wenzhou 325000, Zhejiang Province, China. lmq0906@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 14, 2024; 30(42): 4518-4522 Published online Nov 14, 2024. doi: 10.3748/wjg.v30.i42.4518
Sepsis-associated liver injury: Mechanisms and potential therapeutic targets
Jia-Wen Chen, Chen-Yi Liu, Shu Li, Shi-Wen Wu, Chao Cai, Ming-Qin Lu
Jia-Wen Chen, Chen-Yi Liu, Shu Li, Shi-Wen Wu, Chao Cai, Ming-Qin Lu, Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Co-corresponding authors: Chao Cai and Ming-Qin Lu.
Author contributions: Chen JW designed the outline of the manuscript; Chen JW, Liu CY, and Li S contributed to the writing of the manuscript; Cai C supervised and took responsibility for planning and executing the research activities; Lu MQ developed the concept for the article and provided writing ideas; All authors read and approved the final version of the manuscript to be published.
Supported byThe Zhejiang Medical and Health Science and Technology Program, China, No. 2021KY205 and No. 2024KY139; and The Wenzhou Science and Technology Plan Project, China, No. Y2023111.
Conflict-of-interest statement: The authors declare that there are no financial or other conflicts of interest that could influence the content or conclusions of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Qin Lu, Doctor, MD, Chief Physician, Professor, Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, No. 1 Fanhai West Road, Ouhai District, Wenzhou 325000, Zhejiang Province, China. lmq0906@163.com
Received: September 5, 2024 Revised: September 20, 2024 Accepted: September 26, 2024 Published online: November 14, 2024 Processing time: 55 Days and 22.2 Hours
Abstract
In this editorial, we examined a recent article in the World Journal of Gastroenterology that focused on sepsis-associated liver injury (SLI) and its treatment. SLI is a serious complication of sepsis, primarily caused by microcirculatory disturbances, the gut-liver axis, and inflammatory responses. Specific treatment recommendations for SLI are lacking. The gut-liver axis represents a potential therapeutic target, with metformin showing promise in modulating the gut microbiome and enhancing intestinal barrier function. Although immunomodulatory therapies are being explored, anti-tumor necrosis factor agents and interleukin-1 receptor antagonists have not demonstrated significant clinical benefits. Statins may reduce liver inflammation and prevent injury in sepsis, but their clinical application is limited. Reduced D-related human leucocyte antigen expression on monocytes and lymphocytes suggests immune suppression in patients, indicating that corticosteroids could reverse clinical deterioration in severe infections and address adrenal cortical insufficiency. Current large-scale studies on glucocorticoid therapy for sepsis have yielded mixed results, likely due to inadequate assessment of the immune status of the host. Future research should prioritize the development of personalized immunotherapy tailored to patients’ immune profiles, focusing on identifying novel indicators of immune status and advancing immunomodulatory targets and therapeutics for septic patients.
Core Tip: Immunosuppression is a key aspect of progressive sepsis. Assessing this state is crucial for managing sepsis-associated liver injury and guiding therapeutic choices. Suppression of D-related human leucocyte antigen expression, along with changes in clinical presentation and tests, may indicate an immunosuppressive phase. Hormonal interventions based on D-related human leucocyte antigen levels could potentially alter outcomes in severe infections. However, large-scale studies on glucocorticoid therapy for sepsis show inconsistent results, likely due to inadequate assessment of the immune status of the host.
