Liver failure and glucocorticoid resistance
10.3760/cma.j.cn501113-20200629-00349
- VernacularTitle:肝功能衰竭与糖皮质激素抵抗
- Author:
Xin WANG
1
;
Hongrui XU
;
Yadong WANG
;
Chuan SHEN
;
Caiyan ZHAO
Author Information
1. 河北医科大学第三医院感染科，石家庄 050051；天津市宝坻区中医医院 301800
- Keywords:
Liver failure;
Glucocorticoids;
Inflammatory reaction;
Signal pathway
- From:
Chinese Journal of Hepatology
2020;28(10):888-892
- CountryChina
- Language:Chinese
-
Abstract:
The main pathogenesis of liver failure is immune damage and uncontrolled inflammatory response. Glucocorticoids have strong immunosuppressive and anti-inflammatory effects, and are considered to be useful for the treatment of liver failure. However, the results of many clinical studies have shown that the application of glucocorticoids in patients with liver failure cannot effectively improve the prognosis, but instead increases the chance of infection and endangers life. Provided that, it seems reasonable to assume that glucocorticoid resistance exists in patients with liver failure. This article analyzes the mechanism by which P-glycoprotein reverses glucocorticoid transport, intracellular glucocorticoid signaling pathway dysfunction and related gene mutations when the inflammatory response is uncontrolled. In addition, we also evaluated the sensitivity of glucocorticoids in patients with liver failure, so as to provide theoretical basis for efficacy and medication timing.
