Patterns of dendritic cell and monocyte subsets are associated with disease severity and mortality in liver cirrhosis patients

• Published in: Scientific reports Vol. 11; no. 1; p. 5923
• Main Authors: Cardoso, Chandra Chiappin, Matiollo, Camila, Pereira, Carolina Hilgert Jacobsen, Fonseca, Janaina Santana, Alves, Helder Emmanuel Leite, da Silva, Otavio Marcos, de Souza Menegassi, Vivian, dos Santos, Claudia Regina, de Moraes, Ana Carolina Rabello, de Lucca Schiavon, Leonardo, Santos-Silva, Maria Claudia
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 15-03-2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250/249/1570; 631/250/2504/133/1412; 631/250/2504/133/2505; 631/250/2504/342; Adult; Aged; Biomarkers; Case-Control Studies; Cell Count; Cell Plasticity; Cirrhosis; Cytokines - metabolism; Dendritic cells; Dendritic Cells - immunology; Dendritic Cells - metabolism; Disease Susceptibility; Female; Flow cytometry; Histocompatibility antigen HLA; Humanities and Social Sciences; Humans; Immunophenotyping; Inflammation Mediators - metabolism; Interleukin 10; Interleukin 6; L-selectin; Liver; Liver cirrhosis; Liver Cirrhosis - diagnosis; Liver Cirrhosis - etiology; Liver Cirrhosis - metabolism; Liver Cirrhosis - mortality; Liver diseases; Macrophages; Male; Middle Aged; Monocytes; Monocytes - immunology; Monocytes - metabolism; Mortality; multidisciplinary; Plasma levels; Prognosis; Science; Science (multidisciplinary); Severity of Illness Index
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-85148-y

Liver cirrhosis is often complicated by an immunological imbalance known as cirrhosis-associated immune dysfunction. This study aimed to investigate disturbances in circulating monocytes and dendritic cells in patients with acute decompensation (AD) of cirrhosis. The sample included 39 adult cirrhotic patients hospitalized for AD, 29 patients with stable cirrhosis (SC), and 30 healthy controls (CTR). Flow cytometry was used to analyze monocyte and dendritic cell subsets in whole blood and quantify cytokines in plasma samples. Cirrhotic groups showed higher frequencies of intermediate monocytes (iMo) than CTR. AD patients had lower percentages of nonclassical monocytes than CTR and SC. Cirrhotic patients had a profound reduction in absolute and relative dendritic cell numbers compared with CTR and showed higher plasmacytoid/classical dendritic cell ratios. Increased plasma levels of IL-6, IL-10, and IL-17A, elevated percentages of CD62L
+
monocytes, and reduced HLA-DR expression on classical monocytes (cMo) were also observed in cirrhotic patients. Patients with more advanced liver disease showed increased cMo and reduced tissue macrophages (TiMas) frequencies. It was found that cMo percentages greater than 90.0% within the monocyte compartment and iMo and TiMas percentages lower than 5.7% and 8.6%, respectively, were associated with increased 90-day mortality. Monocytes and dendritic cells are deeply altered in cirrhotic patients, and subset profiles differ between stable and advanced liver disease. High cMo and low TiMas frequencies may be useful biomarkers of disease severity and mortality in liver cirrhosis.