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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2015; 21(42): 11904-11913
Published online Nov 14, 2015. doi: 10.3748/wjg.v21.i42.11904
Published online Nov 14, 2015. doi: 10.3748/wjg.v21.i42.11904
Immune dysfunction in acute alcoholic hepatitis
Ashwin D Dhanda, Peter L Collins, School of Clinical Sciences, University of Bristol, BS2 8HW Bristol, United Kingdom
Ashwin D Dhanda, NIHR Academic Clinical Lecturer in Hepatology, Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, PL6 8BU Plymouth, United Kingdom
Ashwin D Dhanda, South West Liver Unit, Plymouth Hospitals NHS Trust, PL6 8BU Plymouth, United Kingdom
Peter L Collins, Department of Liver Medicine, University Hospitals Bristol NHS Foundation Trust, BS2 8HW Bristol, United Kingdom
Author contributions: Dhanda AD wrote the paper; Collins PL revised the paper.
Conflict-of-interest statement: Both authors declare that no conflict of interest exists.
Open-Access: 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/
Correspondence to: Ashwin D Dhanda, MRCP, PhD, NIHR Academic Clinical Lecturer in Hepatology, Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, John Bull Building, Research Way, Devon, PL6 8BU Plymouth, United Kingdom. ashwin.dhanda@plymouth.ac.uk
Telephone: +44-1752-437444
Received: April 13, 2015
Peer-review started: April 15, 2015
First decision: May 18, 2015
Revised: June 3, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: November 14, 2015
Peer-review started: April 15, 2015
First decision: May 18, 2015
Revised: June 3, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: November 14, 2015
Core Tip
Core tip: Acute alcoholic hepatitis (AAH) has high short-term mortality and is challenging to treat with only glucocorticoids demonstrating proven survival benefit. Development of other effective treatment requires a clear understanding of the mechanisms of immune dysfunction in AAH. Here, we review recent progress in the field and identify areas in need of further research; particularly the role of gut dysbiosis in allowing presentation of pathogen associated molecular patterns to innate receptors on myeloid cells and the subsequent recruitment of immune cell subsets. Recent data demonstrating that T cells have an exhausted phenotype and result in impaired antimicrobial defence is also discussed.