Macrophage activation markers are associated with infection and mortality in patients with acute liver failure
Bibliographic record
Abstract
Abstract Background and Aims Acute liver failure is a multisystem disorder with a high mortality and frequent need for emergency liver transplantation. Following massive innate immune system activation, soluble markers of macrophage activation are released during liver damage and their association with disease severity and prognosis requires exploration. Methods Patients ALF from the United States Acute Liver Failure Study Group (USALFSG, n = 224) and King's College Hospital ( n = 40) together with healthy controls (HC, n = 50) were recruited. Serum from early (Days 1–3) and late (>Day 3) time points were analysed for MAMs by enzyme‐linked immunosorbent assay correlated to markers of illness severity and 21‐day spontaneous survival. Surface expression phenotyping was performed via Flow Cytometry on CD14 + monocytes. Results All MAMs serum concentrations were significantly higher in ALF compared to controls ( p < .0001). sCD206 concentration was higher in early and late stages of the disease in patients with bacteraemia ( p = .002) and infection in general ( p = .006). In MELD‐adjusted multivariate modelling, sCD206 and sCD163 were independently associated with mortality. CD14 + monocyte expression of CD206 ( p < .001) was higher in patients with ALF compared with controls and correlated with SOFA score ( p = .018). sCD206 was independently validated as a predictor of infection in an external cohort. Conclusions sCD206 is increased in serum of ALF patients with infections and poor outcome and is upregulated on CD14 + monocytes. Later measurements of sCD163 and sCD206 during the evolution of ALF have potential as mechanistic predictors of mortality. sCD206 should be explored as a biomarker of sepsis and mortality in ALF.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".