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 Printable version |
The systemic inflammatory response syndrome: a key role on the prognosis of cirrhotic patients |
Hépato-Gastro. Volume 18, Number 6, 607-14, Novembre-Décembre 2011, Mini-revue
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 Résumé
Texte intégral
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Author(s) : Delphine Weil, Jean-Paul Cervoni, Sébastien Pili-Floury, Thierry Thévenot, Vincent Di Martino |
Summary : Confined to the affected organ, the inflammatory reaction is beneficial because it helps the healing process. In some cases, the reaction can be generalized to the entire body and leads to systemic inflammatory response syndrome (SIRS). The massive release of pro-inflammatory cytokines and activation of dysregulated immune cells can lead to a loss of homeostasis and multiorgan failure The pathophysiological changes (including bacterial translocation) induced by cirrhosis on the inflammatory response, the hemodynamic and haemostasis seem to promote the onset or worsening of SIRS. The pejorative impact of SIRS has been widely demonstrated in critically ill patients. In cirrhosis, SIRS might also be a major prognostic factor. It has been shown that the presence of SIRS is common in patients hospitalized for complications of cirrhosis and is closely associated with encephalopathy, hepatorenal syndrome and intra-hospital death. Early detection or validation of surrogate markers of SIRS, such as C-reactive protein, could open new perspectives in the management of our sickest patients at high risk for cirrhosis-related complications. |
Keywords : cirrhosis, SIRS, CRP, IL, Interleukine, SRIS, Syndrome de réponse inflammatoire systémique, TLR, Toll like receptor, LPS, Lipopolysaccharide, NF-κB, Nuclear factor κB |
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