Figure 5.

Schematic version of our hypothesis that prophylactic human albumin infusions improve immune response in ACLF via 2 mechanisms. (A) HAS increases circulating albumin concentration and function improving binding of immunosuppressive PGE₂, reducing free/bioactive PGE₂ and restoring monocyte/macrophage function. (B) Patients with ACLF can be divided into hypoinflammatory and hyperinflammatory responses defined by LM metabolomics, both with potential adverse outcomes. HAS rectifies this LM imbalance leading to a normalized, appropriate inflammatory response with potential improved outcome. IV, intravenous