Noi biomarkeri pentru detectarea infecţiilor bacteriene la pacienţii cu ciroză

Abstract

Life expectancy of patients with liver cirrhosis is closely linked to the degree of liver dysfunction and the occurrence of bacterial infection. An early diagnosis of infection helps to initiate adequate and timely measures and improves outcome of cirrhotic patients. New determinants of prognosis in patients with liver cirrhosis and bacterial infections have been identified in recent years. Recent changes in epidemiology and new findings in pathophysiology have been reported. This review deals with the new determinants of prognosis in patients with cirrhosis and bacterial infections reported recently. It has been reported an association between endothelial dysfunction and higher portal pressure and more episodes of decompensation of cirrhosis. In summary, endothelial dysfunction is clearly associated with poor prognosis and vWF should be taken into account in predictive models in hospitalized patients. The present article provides several lines of evidence to suggest that endocan acts as mediator of inflammatory state associated with bacterial infection in liver cirrhosis, and larger prospective studies should investigate the practical clinical value of serum endocam measurements.