Inflammasome-Driven Fatal Acute-on-Chronic Liver Failure Triggered by Mild COVID-19.

IF 3.8 3区医学 Q2 VIROLOGY Viruses-Basel Pub Date : 2024-10-21 DOI:10.3390/v16101646

Vivian Chih-Wei Chen, Craig Ryan Joseph, Wharton O Y Chan, Wan Rong Sia, Qi Su, Xin Xiu Sam, Hemavathi Tamilarasan, Yun Yan Mah, Wei Lun Ng, Joe Yeong, Lin-Fa Wang, Thinesh L Krishnamoorthy, Wei-Qiang Leow, Matae Ahn, Wan Cheng Chow

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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.

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轻度 COVID-19 引发炎症体驱动的致命急性肝衰竭

炎症球体与许多炎症性疾病有关，包括 COVID-19 和自身免疫性肝病。据报道，严重的 COVID-19 会加重肝功能衰竭，而我们报告了一名稳定的原发性胆汁性胆管炎-自身免疫性肝炎重叠综合征患者因轻度 COVID-19 感染而引发的致命性急性-慢性肝功能衰竭（ACLF）。死后肝脏活检显示，SARS-CoV-2感染的巨噬细胞稀少，而ASC（含有CARD的凋亡相关斑点样蛋白）斑点阳性肝细胞广泛存在，与循环中ASC斑点和炎性细胞因子升高相关，血液中单核细胞亚群减少，表明肝脏炎性体被广泛激活。这是首次报道由轻微远程病毒感染引发的自身免疫性肝病的致命性炎症级联，希望能阐明 ACLF 的一种较少描述的病理生理学，从而促使人们考虑新的诊断和治疗方案。

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来源期刊

Viruses-Basel VIROLOGY-

CiteScore

7.30

自引率

12.80%

发文量

2445

审稿时长

1 months

期刊介绍： Viruses (ISSN 1999-4915) is an open access journal which provides an advanced forum for studies of viruses. It publishes reviews, regular research papers, communications, conference reports and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. We also encourage the publication of timely reviews and commentaries on topics of interest to the virology community and feature highlights from the virology literature in the ''News and Views'' section. Electronic files or software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.