Figure 2.

Role of systemic inflammation in the development of organ failure in cirrhosis. Increased bacterial translocation results in increased PAMPs which trigger low-grade systemic inflammation in cirrhosis. A precipitating event, such as bacterial infection, spikes of bacterial translocation and/or increased hepatocyte death lead to a further rise in PAMPs and DAMPs causing high-grade systemic inflammation. Both immunopathology, direct immune-mediated tissue damage, and metabolic reallocation, counteraction of the nutrient deficit caused by the activated immune system, lead to cell death and mitochondrial dysfunction resulting in organ failure. Created with biorender.com. DAMPS, damage-associated molecular patterns; PAMPS, pathogen-associated molecular patterns.