Mary Wilson
Well-known member
Published: 21 October 2024
https://doi.org/10.3390/v16101646
Chen, V.C.-W.; Joseph, C.R.; Chan, W.O.Y.; Sia, W.R.; Su, Q.; Sam, X.X.; Tamilarasan, H.; Mah, Y.Y.; Ng, W.L.; Yeong, J.; et al.
Abstract
Inflammasome is linked to many inflammatory diseases, including COVID-19 and autoimmune liver diseases. While severe COVID-19 was reported to exacerbate liver failure, we report a fatal acute-on-chronic liver failure (ACLF) in a stable primary biliary cholangitis-autoimmune hepatitis overlap syndrome patient triggered by a mild COVID-19 infection. Postmortem liver biopsy showed sparse SARS-CoV-2-infected macrophages with extensive ASC (apoptosis-associated speck-like protein containing a CARD) speck-positive hepatocytes, correlating with elevated circulating ASC specks and inflammatory cytokines, and depleted blood monocyte subsets, indicating widespread liver inflammasome activation. This first report of a fatal inflammatory cascade in an autoimmune liver disease triggered by a mild remote viral infection hopes to elucidate a less-described pathophysiology of ACLF that could prompt consideration of new diagnostic and therapeutic options.
https://www.mdpi.com/1999-4915/16/10/1646
https://doi.org/10.3390/v16101646
Chen, V.C.-W.; Joseph, C.R.; Chan, W.O.Y.; Sia, W.R.; Su, Q.; Sam, X.X.; Tamilarasan, H.; Mah, Y.Y.; Ng, W.L.; Yeong, J.; et al.
Abstract
Inflammasome is linked to many inflammatory diseases, including COVID-19 and autoimmune liver diseases. While severe COVID-19 was reported to exacerbate liver failure, we report a fatal acute-on-chronic liver failure (ACLF) in a stable primary biliary cholangitis-autoimmune hepatitis overlap syndrome patient triggered by a mild COVID-19 infection. Postmortem liver biopsy showed sparse SARS-CoV-2-infected macrophages with extensive ASC (apoptosis-associated speck-like protein containing a CARD) speck-positive hepatocytes, correlating with elevated circulating ASC specks and inflammatory cytokines, and depleted blood monocyte subsets, indicating widespread liver inflammasome activation. This first report of a fatal inflammatory cascade in an autoimmune liver disease triggered by a mild remote viral infection hopes to elucidate a less-described pathophysiology of ACLF that could prompt consideration of new diagnostic and therapeutic options.
https://www.mdpi.com/1999-4915/16/10/1646