{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:27:42Z","timestamp":1790746062719,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol. Commun."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>\n                    Neutrophils are the most abundant white blood cell in the body and are key participants in the defense against fungal infections. Fungal infections occur often in patients with cirrhosis and are associated with increased 30\u2010day and 90\u2010day mortality. Previous studies have shown that specific neutrophil functions are abnormal in patients with cirrhosis, although the extent of neutrophil dysfunction is not well understood. We tested the ability of neutrophils from 21 hospitalized patients with cirrhosis and 23 healthy control patients to kill\n                    <jats:italic toggle=\"yes\">Candida albicans<\/jats:italic>\n                    , a common fungal pathogen in patients with cirrhosis. Using an assay, we also measured the ability of neutrophils to coordinate multicellular, synchronized control of\n                    <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                    hyphae through a process known as swarming. We found that neutrophils from patients with cirrhosis have significantly decreased fungicidal capacity compared with healthy control neutrophils (53% vs. 74%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.0001) and diminished ability to control hyphal growth normalized as a ratio to healthy control (0.22 vs. 0.65,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.0001). Moreover, serum from patients with cirrhosis decreases the ability of healthy control neutrophils to kill\n                    <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                    (from 60% to 41%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.003). Circulating concentration of the inflammatory cytokines tumor necrosis factor \u03b1, interleukin\u20106, and interleukin\u20108 were found to be significantly elevated in patients with cirrhosis compared to healthy controls. Following pretreatment with granulocyte\u2010colony stimulating factor and granulocyte\u2010macrophage colony\u2010stimulating factor, neutrophil function was restored to almost that of healthy controls.\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    Our data establish profound neutrophil dysfunction against, and altered swarming to,\n                    <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                    in patients with cirrhosis. This dysfunction can be partially reversed with cytokine augmentation\n                    <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1002\/hep4.1645","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T02:38:01Z","timestamp":1609900681000},"page":"502-515","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Loss of Coordinated Neutrophil Responses to the Human Fungal Pathogen, Candida albicans, in Patients With Cirrhosis"],"prefix":"10.1097","volume":"5","author":[{"given":"Sally A.I.","family":"Knooihuizen","sequence":"first","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie J.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Hopke","sequence":"additional","affiliation":[{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Department of Surgery,Center for Engineering in Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Shriners Burns Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Barros","sequence":"additional","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Viens","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie J.","family":"Atallah","sequence":"additional","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina","family":"Dagher","sequence":"additional","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Division of Infectious Diseases,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Irimia","sequence":"additional","affiliation":[{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Department of Surgery,Center for Engineering in Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Shriners Burns Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Medicine,Massachusetts General Hospital,Boston,MA,USA"},{"name":"Harvard Medical School,Boston,MA,USA"},{"name":"Liver Center and Gastrointestinal Division,Massachusetts General Hospital,Boston,MA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8892-8695","authenticated-orcid":false,"given":"Michael 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