Article first published online: 6 JUL 2012
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 56, Issue 2, pages 735–746, August 2012
How to Cite
Antoniades, C. G., Quaglia, A., Taams, L. S., Mitry, R. R., Hussain, M., Abeles, R., Possamai, L. A., Bruce, M., McPhail, M., Starling, C., Wagner, B., Barnardo, A., Pomplun, S., Auzinger, G., Bernal, W., Heaton, N., Vergani, D., Thursz, M. R. and Wendon, J. (2012), Source and characterization of hepatic macrophages in acetaminophen-induced acute liver failure in humans. Hepatology, 56: 735–746. doi: 10.1002/hep.25657
Potential conflict of interest: Dr. Heaton is on the speakers' bureau of Astellas. Dr. Auzinger advises Pfizer.
Supported by a Medical Research Foundation/Medical Research Council Liver Transplant Grant Award. Charalambos Gustav Antoniades is supported by the National Institute of Health Research and EASL Sheila Sherlock Physician Scientist Fellowship.
- Issue published online: 25 JUL 2012
- Article first published online: 6 JUL 2012
- Accepted manuscript online: 15 FEB 2012 04:08AM EST
- Manuscript Accepted: 8 FEB 2012
- Manuscript Received: 7 NOV 2011
Acetaminophen-induced acute liver failure (AALF) is associated with innate immunity activation, which contributes to the severity of hepatic injury and clinical outcome. A marked increase in hepatic macrophages (h-mϕ) is observed in experimental models of AALF, but controversy exists regarding their role, implicating h-mϕ in both aggravation and resolution of liver injury. The role of h-mϕ in human AALF is virtually unexplored. We sought to investigate the role of chemokine (C-C motif) ligand 2 (CCL2) in the recruitment of circulating monocytes to the inflamed liver and to determine how the h-mϕ infiltrate and liver microenvironment may contribute to tissue repair versus inflammation in AALF. We evaluated circulating monocytes, their chemokine (C-C motif) receptor 2 (CCR2) expression, and serum CCL2 levels in patients with AALF. Cell subsets and numbers of circulation-derived (MAC387+) or resident proliferating (CD68/Ki67+) h-mϕ in hepatic immune infiltrates were determined by immunohistochemistry. Inflammatory cytokine levels were determined in whole and laser microdissected liver tissue by proteome array. In AALF, circulating monocytes were depleted, with the lowest levels observed in patients with adverse outcomes. CCL2 levels were high in AALF serum and hepatic tissue, and circulating monocyte subsets expressed CCR2, suggesting CCL2-dependent hepatic monocyte recruitment. Significant numbers of both MAC387+ and CD68+ h-mϕ were found in AALF compared with control liver tissue with a high proportion expressing the proliferation marker Ki67. Levels of CCL2, CCL3, interleukin (IL)-6, IL-10, and transforming growth factor-β1 were significantly elevated in AALF liver tissue relative to chronic liver disease controls. Conclusion: In AALF, the h-mϕ population is expanded in areas of necrosis, both through proliferation of resident cells and CCL2-dependent recruitment of circulating monocytes. The presence of h-mϕ within an anti-inflammatory/regenerative microenvironment indicates that they are implicated in resolution of inflammation/tissue repair processes during AALF. (HEPATOLOGY 2012)