PD-L1 and the risk of bacterial infection in patients with chronic liver diseases: An international multicohort study

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dc.coverageDOI: 10.1016/j.jhepr.2025.101597
dc.creatorJuanola, Adrià
dc.creatorMezzano, Gabriel
dc.creatorPose, Elisa
dc.creatorMoreta, Maria J.
dc.creatorIncicco, Simone
dc.creatorGagliardi, Roberta
dc.creatorJohansen, Stine
dc.creatorTorp, Nikolaj
dc.creatorIsraelsen, Mads
dc.creatorJiménez-Esquivel, Natalia
dc.creatorCastillo-Iturra, Joaquin
dc.creatorRibera, Jordi
dc.creatorGratacós-Ginès, Jordi
dc.creatorSoria, Anna
dc.creatorCárdenas, Andrés
dc.creatorPérez-Guasch, Martina
dc.creatorCervera, Marta
dc.creatorNadal, Ruth
dc.creatorHerms, Queralt
dc.creatorTonon, Marta
dc.creatorHansen, Torben
dc.creatorStankevic, Evelina
dc.creatorHuang, Yun
dc.creatorVargas, Victor
dc.creatorZaccherini, Giacomo
dc.creatorAlessandria, Carlo
dc.creatorUschner, Frank E.
dc.creatorBeuers, Ulrich
dc.creatorFrancoz, Claire
dc.creatorMookerjee, Rajeshwar P.
dc.creatorLaleman, Wim
dc.creatorSolé, Cristina
dc.creatorBañares, Rafael
dc.creatorCuyàs, Berta
dc.creatorAriza, Xavi
dc.creatorColl, Mar
dc.creatorGraupera, Isabel
dc.creatorFabrellas, Núria
dc.creatorMorales-Ruiz, Manuel
dc.creatorThiele, Maja
dc.creatorKrag, Aleksander
dc.creatorAngeli, Paolo
dc.creatorPiano, Salvatore
dc.creatorSolà, Elsa
dc.creatorGinès, Pere
dc.date2025
dc.date.accessioned2026-01-05T21:18:42Z
dc.date.available2026-01-05T21:18:42Z
dc.description<p>Background &amp; Aims: Impaired phagocytic capacity due to activation of the PD-1/PD-L1 pathway has been implicated in the development of bacterial infections in patients with cirrhosis. Soluble PD-L1 (sPD-L1) is easily measurable in plasma and has been proposed as a biomarker of sepsis. In the current study, we aim to evaluate the role of sPD-L1 as a biomarker of bacterial infection development in patients with cirrhosis. Methods: Plasma samples from 995 patients with chronic liver disease grouped in three cohorts were analyzed: an initial cohort of 268 hospitalized patients with acute decompensated cirrhosis, 327 out-patients with non-acute decompensated cirrhosis and finally 400 patients with high-risk alcohol consumption, including all stages of liver fibrosis, from mild/no fibrosis to cirrhosis (F0–F4). The main outcomes of the study were development of bacterial infection and mortality. Results: Patients who developed bacterial infections had higher median levels of sPD-L1 than those who did not (160 [IQR 116-221] vs. 136 [IQR 97-193] pg/ml, respectively, p value &lt;0.001; hazard ratio 1.034, 95% CI 1.014-1.055). Levels of sPD-L1 were associated with bacterial infection development after adjustment for confounding factors. During follow-up, patients who died had higher median sPD-L1 levels than survivors, after adjustment for MELD Na (180 [IQR 143-267] vs. 134 [IQR 97-187] pg/ml, respectively; p value &lt;0.001; HR 1.066, 95% CI 1.043-1.089). These findings were observed in all cohorts. Conclusions: Plasma levels of sPD-L1 are associated with the risk of bacterial infection development irrespective of the stage of chronic liver disease. Furthermore, higher sPD-L1 levels are linked to increased mortality. Measurement of sPD-L1 levels may help identify patients at high risk of developing bacterial infections and guide the implementation of new preventive strategies. Impact and implications: This study explores the role of soluble PD-L1 as a biomarker of immune dysfunction and its association with clinical outcomes in patients with chronic liver disease. Our findings demonstrate that soluble PD-L1 levels increase with the progression of liver disease and they are independently associated with an increased risk of bacterial infection development and mortality. These results could help physicians identify high-risk individuals earlier and implement preventive strategies.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/ab15fd3e-bff7-4730-9a4f-4d765f8ec3b2
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/68157
dc.languageeng
dc.rightsinfo:eu-repo/semantics/openAccess
dc.sourcevol.7 (2025) nr.12
dc.subjectBacterial infection
dc.subjectBiomarkers
dc.subjectDecompensated cirrhosis
dc.subjectLiver cirrhosis
dc.subjectMortality
dc.subjectPD-L1
dc.titlePD-L1 and the risk of bacterial infection in patients with chronic liver diseases: An international multicohort studyeng
dc.typeArticleeng
dc.typeArtículospa
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