Liver damage, caused by fibrosis, is the 14th most common cause of death in adults worldwide. In addition to this, it is a major risk factor for infections, where patients with chronic liver fibrosis (cirrhosis) are more likely to acquire infections, and to die from these infections in hospitals, when compared to other patients. As such, this poses a major health burden in Europe and the wider world. The healthy liver is full of immune cells which sit in the bloodstream and constantly survey for damage and infections. One of the cells most suited for this role are the liver resident macrophages. During fibrosis we know that these resident cells are lost and replaced by diverse populations of inflammatory macrophages. We believe that this plays a role in the increased susceptibility to infections in cirrhotic patients. Therefore, in this work this project aimed to understand the following:
Identify changes occurring in the immune cells in the fibrotic liver
Find genes which can become therapeutic targets in the immune cells
Improve the response to infections in cirrhosis via these targets
Taken together, this work aimed to improve the understanding of the role of macrophages in the liver during cirrhosis and infections. This was in order to improve the response in patients and lessen the health burden worldwide, both from chronic liver disease and from sepsis, the inappropriate and severe response to infection. This could improve the treatment and detection of infections within cirrhotic patients, leading to new avenues of research and potential targetable mechanisms.