title: Albumin in chronic liver disease: structure, functions and therapeutic implications.
abstract: Human serum albumin is a critical plasma protein produced by the liver with a number of accepted clinical indications in chronic liver disease including management of circulatory and renal dysfunction in patients with ascites. Advanced cirrhosis is characterised by reduced albumin concentration as well as impaired albumin function as a result of specific structural changes and oxidative damage. Traditionally, the biologic and therapeutic role of albumin in liver disease was attributed to its oncotic effects but it is now understood that albumin has a wide range of other important physiologic functions such as immunomodulation, endothelial stabilisation, antioxidant effects and binding multiple drugs, toxins and other molecules. This review discusses the multifunctional properties of albumin and, in particular, the biologic and clinical implications of structural and functional changes of albumin that are associated with cirrhosis. Based on these insights, we explore the current and potential future therapeutic uses of albumin in liver disease.
authors.affiliation: Liver Failure Group, Institute for Liver and Digestive Health, University College London, Royal Free Hospital, London, NW3 2PF, UK. r.spinella@ucl.ac.uk.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Spinella
authors.affiliation: Liver Failure Group, Institute for Liver and Digestive Health, University College London, Royal Free Hospital, London, NW3 2PF, UK.
authors.forename: Rohit
authors.initials: R
authors.lastname: Sawhney
authors.affiliation: Liver Failure Group, Institute for Liver and Digestive Health, University College London, Royal Free Hospital, London, NW3 2PF, UK. r.jalan@ucl.ac.uk.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Jalan
mesh_terms: D006530:Hepatorenal Syndrome / Q000097:blood / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000378:metabolism / Q000628:therapy; D008107:Liver Diseases / Q000097:blood / Q000628:therapy; D008958:Models, Molecular; D012709:Serum Albumin / Q000737:chemistry* / Q000378:metabolism* / Q000627:therapeutic use
chemical_list: D012709:Serum Albumin
keywords: Albumin function; Chronic liver disease; Cirrhosis; Human serum albumin; Non oncotic functions; Oxidation