Journal of Shanghai Jiao Tong University (Medical Science) >

2023 , Vol. 43 >Issue 1: 95 - 100

DOI: https://doi.org/10.3969/j.issn.1674-8115.2023.01.012

Review

Advances in decompensated cirrhosis treatment by human serum albumin

  • Chenxi ZHANG ,
  • Zhujun CAO ,
  • Xiaogang XIANG ,
  • Qing XIE ,
  • Jiawei GENG
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  • 1.Kunming University of Science and Technology School of Medicine, Kunming 650500, China
    2.Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    3.Department of Infectious Diseases and Liver Diseases, The First People's Hospital of Yunnan Province, Kunming 650500, China
GENG Jiawei, E-mail: jia_wei_geng@163.com.

Received date: 2022-06-14

  Accepted date: 2022-11-30

  Online published: 2023-01-28

Supported by

National Science and Technology Major Project of the 13th Five-Year Plan of China(2017ZX10203201-008);National Natural Science Foundation of China(82070604);Innovative Research Team Program Foundation of Yunnan Province(202005AE160010);Ten-Thousands Talents Program Foundation of Yunnan Province(YNWR-MY-2019-072)

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Abstract

Human serum albumin (HSA) is one of the most abundant proteins in the plasma which participate in plenty of physiological functions. This article reviews recent advances in HSA-related researches with respect to its synthesis, metabolism, structure, function, and clinical application in decompensated cirrhosis and its adverse events. As a multidomain polyfunctional molecule, HSA has not only shown its effect on colloid osmotic pressure elevation, but also its non-colloid functions including ligand binding capacity, antioxidant ability, immunoregulatory effect, and maintaining the stability of endothelium and permeability of capillary. However, the structure of HSA is easily affected by pathology surroundings including various posttranslational modifications of HSA, such as truncated N-terminal or C-terminal, glycosylation, and oxidation of Cys-34. Among these, the oxidation modification of Cys-34 in HSA is closely related to cirrhosis progression and has a strong prognostic ability of clinical outcomes. Besides prevention of post paracentesis circulatory dysfunction, HSA administration also shows excellent treatment potentials in the cirrhotic complications, including hepatorenal syndrome (HRS) and spontaneous peritonitis (SBP). Furthermore, more clinical trials are needed to discuss the potential benefits of HSA in non-SBP infection, long-term administration of ascites, hepatic encephalopathy, acute-on-chronic liver failure (ACLF) and other cirrhotic complications.

Key words： human serum albumin (HSA); decompensated cirrhosis; ascites; acute-on-chronic liver failure (ACLF)

Cite this article

Chenxi ZHANG , Zhujun CAO , Xiaogang XIANG , Qing XIE , Jiawei GENG . Advances in decompensated cirrhosis treatment by human serum albumin[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(1) : 95 -100 . DOI: 10.3969/j.issn.1674-8115.2023.01.012

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