@article {Brenige201900465, author = {Robert Brenig and Oltin T Pop and Evangelos Triantafyllou and Anne Geng and Arjuna Singanayagam and Christian Perez-Shibayama and Lenka Besse and Jovana Cupovic and Patrizia K{\"u}nzler and Tuyana Boldanova and Stephan Brand and David Semela and Fran{\c c}ois HT Duong and Christopher J Weston and Burkhard Ludewig and Markus H Heim and Julia Wendon and Charalambos G Antoniades and Christine Bernsmeier}, title = {Expression of AXL receptor tyrosine kinase relates to monocyte dysfunction and severity of cirrhosis}, volume = {3}, number = {1}, elocation-id = {e201900465}, year = {2020}, doi = {10.26508/lsa.201900465}, publisher = {Life Science Alliance}, abstract = {Infectious complications in patients with cirrhosis frequently initiate episodes of decompensation and substantially contribute to the high mortality. Mechanisms of the underlying immuneparesis remain underexplored. TAM receptors (TYRO3/AXL/MERTK) are important inhibitors of innate immune responses. To understand the pathophysiology of immuneparesis in cirrhosis, we detailed TAM receptor expression in relation to monocyte function and disease severity prior to the onset of acute decompensation. TNF-α/IL-6 responses to lipopolysaccharide were attenuated in monocytes from patients with cirrhosis (n = 96) compared with controls (n = 27) and decreased in parallel with disease severity. Concurrently, an AXL-expressing (AXL+) monocyte population expanded. AXL+ cells (CD14+CD16highHLA-DRhigh) were characterised by attenuated TNF-α/IL-6 responses and T cell activation but enhanced efferocytosis and preserved phagocytosis of Escherichia coli. Their expansion correlated with disease severity, complications, infection, and 1-yr mortality. AXL+ monocytes were generated in response to microbial products and efferocytosis in vitro. AXL kinase inhibition and down-regulation reversed attenuated monocyte inflammatory responses in cirrhosis ex vivo. AXL may thus serve as prognostic marker and deserves evaluation as immunotherapeutic target in cirrhosis.}, URL = {https://www.life-science-alliance.org/content/3/1/e201900465}, eprint = {https://www.life-science-alliance.org/content/3/1/e201900465.full.pdf}, journal = {Life Science Alliance} }