7±32.8 vs VALF: 11.8±14.5, p=0.0396), basic FGF (8.0±13.0 vs 1.5±3.3, p=0.0211), MIP-1 α (7.5±12.7 vs 1.6±3.9 p=0.0362), and TNF-α (44.4±47.7 vs 18.6±25.2, p=0.0351) in patients with ALF-AF, although their AST and ALT levels were significantly Small molecule library lower than those of VALF. The administrations of immuno-suppressive agents before emergence of HE was contributed to their rescue without liver transplantation. Conclusion: The radiological findings by CT-scan, such as liver atrophy and heterogeneity, in addition of subacute clinical course and higher proinflammatory status were useful for the diagnosis of ALF-AF. Early diagnosis and proper immunosuppressive treatment are necessary for rescue without liver transplantation.
Disclosures: The following people have nothing to disclose: Hirotoshi Ebinuma, Hidetsugu Saito, Yoshiyuki Yamagishi, Nobuhiro Nakamoto, Po-sung Chu, Yuko Wakayama, Nobuhito Taniki, Akihiro Yamaguchi, Shunsuke Shiba, Shingo Usui, Kazuo Sugiyama, Takanori Kanai Purpose: Acute liver failure (ALF) is a serious life threatening ailment. Viral, drug or toxic insults are likely to produce liver injury mediated through CD8+ T-cells. Monocytes/macrophages are the key effector cells of innate immune system. Their plasticity could determine pro-inflammatory (M1 macrophages) /pro-resolutionary (M2 macrophages) state in ALF. A better understanding of macrophage plasticity during ALF could promote immunemodulating therapies
and thus may attenuate Histone Methyltransferase inhibitor liver injury and aid liver regenerative responses. Patients and methods: 24 ALF patients with different etiologies were recruited; HEV-related ALF (HEV-ALF, n=16), ATT induced ALF n= 2, HBV related ALF n= 3, cryptogenic n=3. Phenotypic and functional profile of CD14+ monocytes and CD11b+ CD163+ macro-phages 上海皓元医药股份有限公司 (M2 type macrophages) and their phagocytic activity was determined by the uptake of opsonized E.coli. Reactive oxygen species (ROS) production by macrophages and monocytes was determined,
with and without stimulation of fMLP, E Coli and PMA. Results: Out of 24, only 25% patients with HEV-ALF survived. The frequency of monocyte derived M2 macro-phages was significantly increased in non-survivors (p=0.009). While the phagocytic activity was significantly higher in survivors (38 ± 3% vs. 15 ± 5, p=0.009), ROS production was significantly higher in non-survivors (resting, p=0.04, E. coli, p=0.04, fMLP, p=0.03 & PMA p=0.03) compared to survivors. There was no significant difference in frequency of monocytes and their phagocytic activity between survivors and non-survivors. Conclusion: The frequency of Monocytes derived Macro-phages was high in non-survivors. These cells were polarized towards M2 type showing increased ROS production which may possibly contribute to liver injury resulting in death of patients. Disclosures: The following people have nothing to disclose: Rashi Sehgal, Arshi Khanam, Ashish Vyas, Shiv K.