The term cirrhosis-associated immune dysfunction (CAID) comprises the distinctive spectrum of immune alterations associated with the course of end-stage liver disease. Systemic inflammation and immune deficiency are the key components of CAID. Their severity is highly dynamic and progressive, paralleling cirrhosis stage. CAID involves two different immune phenotypes: the low-grade systemic inflammatory phenotype and the high-grade systemic inflammatory phenotype. The low-grade systemic inflammatory phenotype can be found in patients with compensated disease or clinical decompensation with no organ failure. In this phenotype, there is an exaggerated immune activation but the effector response is not markedly compromised. The high-grade systemic inflammatory phenotype is present in patients with acute-on-chronic liver failure, a clinical situation characterized by decompensation, organ failure and high short-term mortality. Along with high-grade inflammation, this CAID phenotype includes intense immune paralysis that critically increases the risk of infections and worsens prognosis. The intensity of CAID has important consequences on cirrhosis progression and correlates with the severity of liver insufficiency, bacterial translocation and organ failure. Therapies targeting the modulation of the dysfunctional immune response are currently being evaluated in preclinical and clinical studies.

肝硬化相关免疫功能障碍 (CAID) 一词包括与终末期肝病病程相关的一系列独特的免疫改变。全身炎症和免疫缺陷是CAID的关键组成部分。它们的严重程度是高度动态和进行性的，与肝硬化阶段平行。CAID 涉及两种不同的免疫表型：低级别全身炎症表型和高级全身炎症表型。低度全身炎症表型可见于代偿性疾病或临床失代偿但无器官衰竭的患者。在这种表型中，存在夸大的免疫激活，但效应器反应没有明显受损。慢性肝衰竭急性发作的患者存在高度全身性炎症表型，一种以失代偿、器官衰竭和高短期死亡率为特征的临床情况。除了严重的炎症，这种 CAID 表型还包括严重的免疫麻痹，这会严重增加感染风险并恶化预后。CAID 的强度对肝硬化进展具有重要影响，并与肝功能不全、细菌易位和器官衰竭的严重程度相关。目前正在临床前和临床研究中评估针对调节功能失调的免疫反应的疗法。CAID 的强度对肝硬化进展具有重要影响，并与肝功能不全、细菌易位和器官衰竭的严重程度相关。目前正在临床前和临床研究中评估针对调节功能失调的免疫反应的疗法。CAID 的强度对肝硬化进展具有重要影响，并与肝功能不全、细菌易位和器官衰竭的严重程度相关。目前正在临床前和临床研究中评估针对调节功能失调的免疫反应的疗法。