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Physiological Reviews
Article . 2025 . Peer-reviewed
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The liver as a central “hub” of the immune system: pathophysiological implications

Authors: Vincenzo Ronca; Alessio Gerussi; Paul Collins; Alessandro Parente; Ye Htun Oo; Pietro Invernizzi;

The liver as a central “hub” of the immune system: pathophysiological implications

Abstract

The purpose of this review is to describe the immune function of the liver, guiding the reader from the homeostatic tolerogenic status to the aberrant activation demonstrated in chronic liver disease. An extensive description of the pathways behind the inflammatory modulation of the healthy liver will be provided focusing on the complex immune cell network residing within the liver. The limit of tolerance will be presented in the context of organ transplantation, seizing the limits of homeostatic mechanisms that fail in accepting the graft, progressing eventually toward rejection. The triggers and mechanisms behind chronic activation in metabolic liver conditions and viral hepatitis will be discussed. The last part of the review will be dedicated to one of the greatest paradoxes for a tolerogenic organ, developing autoimmunity. Through the description of the three most common autoimmune liver diseases, the autoimmune reaction against hepatocytes and biliary epithelial cells will be dissected.

Keywords

PRIMARY BILIARY-CIRRHOSIS, MUCOSA-ASSOCIATED MICROBIOTA, immunoregulation, autoimmunity, Biology and Life Sciences, ISCHEMIA-REPERFUSION INJURY, HEPATIC STELLATE CELLS, PRIMARY SCLEROSING CHOLANGITIS, CD8(+) T-CELLS, ANTIBODY-MEDIATED REJECTION, immunology, NATURAL-KILLER-CELLS, SINUSOIDAL-ENDOTHELIAL-CELLS, hepatology, FATAL AUTOIMMUNE HEPATITIS, Medicine and Health Sciences, immunotolerance

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
10
Top 10%
Average
Top 10%