Expression of AXL receptor tyrosine kinase relates to monocyte dysfunction and severity of cirrhosis

Robert Brenig, Oltin T Pop, Evangelos Triantafyllou, Anne Geng, Arjuna Singanayagam, Christian Perez-Shibayama, Lenka Besse, Jovana Cupovic, Patrizia Künzler, Tuyana Boldanova, Stephan Brand, David Semela, François Ht Duong, Christopher J Weston, Burkhard Ludewig, Markus H Heim, Julia Wendon, Charalambos G Antoniades, Christine Bernsmeier

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10 Citations (Scopus)
122 Downloads (Pure)


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.

Original languageEnglish
Article numbere201900465
Number of pages16
JournalLife Science Alliance
Issue number1
Early online date10 Dec 2019
Publication statusPublished - Jan 2020

Bibliographical note

© 2019 Brenig et al.

ASJC Scopus subject areas

  • Ecology
  • Biochemistry, Genetics and Molecular Biology (miscellaneous)
  • Plant Science
  • Health, Toxicology and Mutagenesis


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