Welcome to the EF-CLIF web-page, the main working tool of our investigators. All protocols of the multicenter prospective observational studies and randomized controlled trials performed by our network of Hospitals and their clinical research forms are loaded in the reserved research area of the webpage. You will find in other areas detailed information related to the organization, rules, steering committees, research facilities and scientific production as well as the past and the future educational activities of the EF CLIF.
A lesson drawn from the CANONIC study was that among patients with acutely decompensated cirrhosis, systemic inflammation was much more marked in patients with acute-on-chronic liver failure (ACLF) than in those without. The mechanisms explaining exaggerated systemic inflammation in patients with ACLF are poorly understood.READ MORE
48 PIs from all over Europe will gather in Barcelona to review and approve the details of the PREDICT Study, which is expected to start next month This will give us the opportunity to get together all the people involved in the preparation, management and execution of the Study.READ MORE
The Grifols Chair for Translational Research has been recently created because of the results of the CANONIC study showing that acute-on-chronic liver failure (ACLF) was associated with systemic inflammation, assessed with routinely available markers such as white-cell count and plasma C-reactive protein levels (1). The nature of relationships underlying this association were unknown, indicating the need for developing translational research in patients with ACLF and more largely in acutely decompensated patients.In this context, the first achievement of the Grifols Chair was to promote a study that was aimed to elucidate the respective role of systemic inflammation (and is correlate, systemic oxidative stress) and systemic circulatory dysfunction in the development of acutely decompensated cirrhosis with or without ACLF. This study used plasma samples from 522 acutely decompensated patients (237 with ACLF) of the CANONIC cohort. Systemic inflammation was assessed by measuring 29 cytokines and systemic oxidative stress by measuring the form of circulating albumin (called, human nonmercaptalbumin 2), which is irreversibly oxidized at cysteine 34. Systemic circulatory dysfunction was estimated by plasma renin and copeptin concentrations. Measurements were performed at enrollment (baseline) in all patients and sequentially during hospitalization in 255. Plasma from healthy subjects served for control measurements. The results have now been published as a full article (2), that can be considered as a landmark paper. First, it was the description of the inflammatory and circulatory landscape according to absence or presence of ACLF: patients with acute decompensation without ACLF exhibited systemic alterations including marked inflammation, oxidative stress, and circulatory dysfunction; and these systemic features were even more marked in patients with ACLF. Next, it was found that the intensity of systemic inflammation correlated closely with the severity of ACLF at enrollment. Systemic inflammation and ACLF were strongly associated regarding their course (improvement, no change, or worsening). Last but not least, the association of ACLF was closer with systemic inflammation than with circulatory dysfunction. Together these results support systemic inflammation as the primary driver of ACLF in cirrhosis.READ MORE
Dr Trebicka will be the Principal Investigator of the Predict Study, promoted by the EF Clif, which is meant to be fundamental to uncover mechanistic and pathophysiological processes associated with the development and clinical course of ACLF and to identify the precipitating events of ACLF.READ MORE