Albumin in chronic liver disease: structure, functions and therapeutic implications

• Published in: Hepatology international Vol. 10; no. 1; pp. 124 - 132
• Main Authors: Spinella, Rosaria, Sawhney, Rohit, Jalan, Rajiv
• Format: Journal Article Book Review
• Language: English
• Published: New Delhi Springer India 01.01.2016; Springer Nature B.V
• Subjects: Colorectal Surgery; Hepatology; Hepatorenal Syndrome - blood; Hepatorenal Syndrome - therapy; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - metabolism; Liver Cirrhosis - therapy; Liver Diseases - blood; Liver Diseases - therapy; Medicine; Medicine & Public Health; Models, Molecular; Review Article; Serum Albumin - chemistry; Serum Albumin - metabolism; Serum Albumin - therapeutic use; Surgery; Human serum albumin; Cirrhosis; Oxidation; Chronic liver disease; Albumin function; Non oncotic functions
• ISSN: 1936-0533; 1936-0541
• DOI: 10.1007/s12072-015-9665-6

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.