Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF
Background and AimsPatients with cirrhosis and acute-on-chronic liver failure (ACLF) have immunosuppression, indicated by an increase in circulating immune-deficient monocytes. The aim of this study was to investigate simultaneously the major blood-immune cell subsets in these patients.Material and...
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Frontiers Media S.A.
2021-02-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2020.619039/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emmanuel Weiss Emmanuel Weiss Emmanuel Weiss Pierre de la Grange Mylène Defaye Juan José Lozano Ferrán Aguilar Pushpa Hegde Ariane Jolly Lucile Moga Lucile Moga Sukriti Sukriti Banwari Agarwal Haqeeqat Gurm Marion Tanguy Johanne Poisson Joan Clària Joan Clària Joan Clària Joan Clària Paer-Selim Abback Axel Périanin Gautam Mehta Gautam Mehta Gautam Mehta Rajiv Jalan Rajiv Jalan Claire Francoz Pierre-Emmanuel Rautou Pierre-Emmanuel Rautou Sophie Lotersztajn Vicente Arroyo François Durand François Durand Richard Moreau Richard Moreau Richard Moreau |
spellingShingle |
Emmanuel Weiss Emmanuel Weiss Emmanuel Weiss Pierre de la Grange Mylène Defaye Juan José Lozano Ferrán Aguilar Pushpa Hegde Ariane Jolly Lucile Moga Lucile Moga Sukriti Sukriti Banwari Agarwal Haqeeqat Gurm Marion Tanguy Johanne Poisson Joan Clària Joan Clària Joan Clària Joan Clària Paer-Selim Abback Axel Périanin Gautam Mehta Gautam Mehta Gautam Mehta Rajiv Jalan Rajiv Jalan Claire Francoz Pierre-Emmanuel Rautou Pierre-Emmanuel Rautou Sophie Lotersztajn Vicente Arroyo François Durand François Durand Richard Moreau Richard Moreau Richard Moreau Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF Frontiers in Immunology myeloid cells innate lymphoid cells adaptive immune cells sepsis organ failure immunotherapies |
author_facet |
Emmanuel Weiss Emmanuel Weiss Emmanuel Weiss Pierre de la Grange Mylène Defaye Juan José Lozano Ferrán Aguilar Pushpa Hegde Ariane Jolly Lucile Moga Lucile Moga Sukriti Sukriti Banwari Agarwal Haqeeqat Gurm Marion Tanguy Johanne Poisson Joan Clària Joan Clària Joan Clària Joan Clària Paer-Selim Abback Axel Périanin Gautam Mehta Gautam Mehta Gautam Mehta Rajiv Jalan Rajiv Jalan Claire Francoz Pierre-Emmanuel Rautou Pierre-Emmanuel Rautou Sophie Lotersztajn Vicente Arroyo François Durand François Durand Richard Moreau Richard Moreau Richard Moreau |
author_sort |
Emmanuel Weiss |
title |
Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF |
title_short |
Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF |
title_full |
Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF |
title_fullStr |
Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF |
title_full_unstemmed |
Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLF |
title_sort |
characterization of blood immune cells in patients with decompensated cirrhosis including aclf |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2021-02-01 |
description |
Background and AimsPatients with cirrhosis and acute-on-chronic liver failure (ACLF) have immunosuppression, indicated by an increase in circulating immune-deficient monocytes. The aim of this study was to investigate simultaneously the major blood-immune cell subsets in these patients.Material and MethodsBlood taken from 67 patients with decompensated cirrhosis (including 35 critically ill with ACLF in the intensive care unit), and 12 healthy subjects, was assigned to either measurements of clinical blood counts and microarray (genomewide) analysis of RNA expression in whole-blood; microarray (genomewide) analysis of RNA expression in blood neutrophils; or assessment of neutrophil antimicrobial functions.ResultsSeveral features were found in patients with ACLF and not in those without ACLF. Indeed, clinical blood count measurements showed that patients with ACLF were characterized by leukocytosis, neutrophilia, and lymphopenia. Using the CIBERSORT method to deconvolute the whole-blood RNA-expression data, revealed that the hallmark of ACLF was the association of neutrophilia with increased proportions of macrophages M0-like monocytes and decreased proportions of memory lymphocytes (of B-cell, CD4 T-cell lineages), CD8 T cells and natural killer cells. Microarray analysis of neutrophil RNA expression revealed that neutrophils from patients with ACLF had a unique phenotype including induction of glycolysis and granule genes, and downregulation of cell-migration and cell-cycle genes. Moreover, neutrophils from these patients had defective production of the antimicrobial superoxide anion.ConclusionsGenomic analysis revealed that, among patients with decompensated cirrhosis, those with ACLF were characterized by dysregulation of blood immune cells, including increases in neutrophils (that had a unique phenotype) and macrophages M0-like monocytes, and depletion of several lymphocyte subsets (including memory lymphocytes). All these lymphocyte alterations, along with defective neutrophil superoxide anion production, may contribute to immunosuppression in ACLF, suggesting targets for future therapies. |
topic |
myeloid cells innate lymphoid cells adaptive immune cells sepsis organ failure immunotherapies |
url |
https://www.frontiersin.org/articles/10.3389/fimmu.2020.619039/full |
work_keys_str_mv |
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doaj-08bb7077b5d446efbff237f3b2fd3c802021-02-05T07:45:06ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-02-011110.3389/fimmu.2020.619039619039Characterization of Blood Immune Cells in Patients With Decompensated Cirrhosis Including ACLFEmmanuel Weiss0Emmanuel Weiss1Emmanuel Weiss2Pierre de la Grange3Mylène Defaye4Juan José Lozano5Ferrán Aguilar6Pushpa Hegde7Ariane Jolly8Lucile Moga9Lucile Moga10Sukriti Sukriti11Banwari Agarwal12Haqeeqat Gurm13Marion Tanguy14Johanne Poisson15Joan Clària16Joan Clària17Joan Clària18Joan Clària19Paer-Selim Abback20Axel Périanin21Gautam Mehta22Gautam Mehta23Gautam Mehta24Rajiv Jalan25Rajiv Jalan26Claire Francoz27Pierre-Emmanuel Rautou28Pierre-Emmanuel Rautou29Sophie Lotersztajn30Vicente Arroyo31François Durand32François Durand33Richard Moreau34Richard Moreau35Richard Moreau36Assistance Publique—Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, Paris, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainGenoSplice, Paris, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceCIBERehd, Barcelona, SpainEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceGenoSplice, Paris, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceAssistance Publique—Hôpitaux de Paris (APHP), Service d’Hépatologie & Réanimation Hépato Digestive, Hôpital Beaujon, Clichy, FranceDepartment of Research, Institute of Liver and Biliary Sciences, New Delhi, IndiaLiver Failure Group, Institute for Liver and Digestive Health, University College London, London, United KingdomLiver Failure Group, Institute for Liver and Digestive Health, University College London, London, United KingdomUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainCIBERehd, Barcelona, SpainHospital Clínic-August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain0Universitat de Barcelona, Barcelona, SpainUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceLiver Failure Group, Institute for Liver and Digestive Health, University College London, London, United Kingdom1Institute of Hepatology, Foundation for Liver Research, London, United Kingdom2Faculty of Life Sciences & Medicine, King’s College London, London, United KingdomEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainLiver Failure Group, Institute for Liver and Digestive Health, University College London, London, United KingdomAssistance Publique—Hôpitaux de Paris (APHP), Service d’Hépatologie & Réanimation Hépato Digestive, Hôpital Beaujon, Clichy, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceAssistance Publique—Hôpitaux de Paris (APHP), Service d’Hépatologie & Réanimation Hépato Digestive, Hôpital Beaujon, Clichy, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceAssistance Publique—Hôpitaux de Paris (APHP), Service d’Hépatologie & Réanimation Hépato Digestive, Hôpital Beaujon, Clichy, FranceUniversité de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche sur l’Inflammation (CRI), Paris, FranceEuropean Foundation for the study of Chronic Liver Failure (EF-Clif), European Association for the Study of Chronic Liver Failure (EASL-CLIF) Consortium and Grifols Chair, Barcelona, SpainAssistance Publique—Hôpitaux de Paris (APHP), Service d’Hépatologie & Réanimation Hépato Digestive, Hôpital Beaujon, Clichy, FranceBackground and AimsPatients with cirrhosis and acute-on-chronic liver failure (ACLF) have immunosuppression, indicated by an increase in circulating immune-deficient monocytes. The aim of this study was to investigate simultaneously the major blood-immune cell subsets in these patients.Material and MethodsBlood taken from 67 patients with decompensated cirrhosis (including 35 critically ill with ACLF in the intensive care unit), and 12 healthy subjects, was assigned to either measurements of clinical blood counts and microarray (genomewide) analysis of RNA expression in whole-blood; microarray (genomewide) analysis of RNA expression in blood neutrophils; or assessment of neutrophil antimicrobial functions.ResultsSeveral features were found in patients with ACLF and not in those without ACLF. Indeed, clinical blood count measurements showed that patients with ACLF were characterized by leukocytosis, neutrophilia, and lymphopenia. Using the CIBERSORT method to deconvolute the whole-blood RNA-expression data, revealed that the hallmark of ACLF was the association of neutrophilia with increased proportions of macrophages M0-like monocytes and decreased proportions of memory lymphocytes (of B-cell, CD4 T-cell lineages), CD8 T cells and natural killer cells. Microarray analysis of neutrophil RNA expression revealed that neutrophils from patients with ACLF had a unique phenotype including induction of glycolysis and granule genes, and downregulation of cell-migration and cell-cycle genes. Moreover, neutrophils from these patients had defective production of the antimicrobial superoxide anion.ConclusionsGenomic analysis revealed that, among patients with decompensated cirrhosis, those with ACLF were characterized by dysregulation of blood immune cells, including increases in neutrophils (that had a unique phenotype) and macrophages M0-like monocytes, and depletion of several lymphocyte subsets (including memory lymphocytes). All these lymphocyte alterations, along with defective neutrophil superoxide anion production, may contribute to immunosuppression in ACLF, suggesting targets for future therapies.https://www.frontiersin.org/articles/10.3389/fimmu.2020.619039/fullmyeloid cellsinnate lymphoid cellsadaptive immune cellssepsisorgan failureimmunotherapies |