The issue

Scoring and prediction systems such as model for end-stage liver disease (MELD), MELD-Na, and Child–Pugh scores have a poor prognostic value in patients with acute decompensation of cirrhosis. A robust prognostic score focusing on patients with acute decompensation is therefore urgently needed.

Extracellular vesicles are vesicles released outside the cells by all cell types and can be found in all biological fluids such as blood. The composition of extracellular vesicles reflects the type of activation or stress their mother cell was exposed to. Therefore, extracellular vesicles content holds great potential for predicting the disease trajectory. In cirrhosis, detrimental changes occur not only in the liver, but also in many other organs and systems including vessels, immune cells, gut, muscles, and kidneys. Plasma extracellular vesicles exhibit a remarkable potential to capture multiorgan involvement associated with cirrhosis.

The approach

The objective of this project is to characterize plasma large extracellular vesicles profiles associated with the outcome of patients with acute decompensation of cirrhosis by re-analyzing standardized biobank samples from patients included in PREDICT and ACLARA cohorts. This study is embedded in the EU-funded DECISION project.