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.

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Correspondence to Rosaria Spinella or Rajiv Jalan.

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Rosaria Spinella and Rohit Sawhney declare that they have no conflict of interest. Rajiv Jalan has served on the Scientific Advisory Board for Conatus Pharma, has received lecture fees from Gambro and has on-going research collaboration with Gambro, Grifols and is the Principal Investigator of an Industry sponsored study (Sequana Medical). He is also inventor for a drug, l-ornithine phenyl acetate (OCR-002), which UCL has licensed to Ocera Therapeutics. He is also the founder of the UCL spin-out company Yaqrit Ltd. and Cyberliver Ltd.

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Spinella, R., Sawhney, R. & Jalan, R. Albumin in chronic liver disease: structure, functions and therapeutic implications. Hepatol Int 10, 124–132 (2016). https://doi.org/10.1007/s12072-015-9665-6

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Keywords

  • Human serum albumin
  • Cirrhosis
  • Chronic liver disease
  • Non oncotic functions
  • Albumin function
  • Oxidation