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Review

Macrophage Activation Markers, CD163 and CD206, in Acute-on-Chronic Liver Failure

Publicated to:Cells. 9 (5): E1175- - 2020-05-01 9(5), DOI: 10.3390/cells9051175

Authors: Nielsen, MC; Moller, HJ; Gantzel, RH; Gronbæk, H; Clària, J; Trebicka, J

Affiliations

Aarhus Univ Hosp, Dept Clin Biochem, DK-8200 Aarhus N, Denmark - Author
Aarhus Univ Hosp, Dept Hepatol & Gastroenterol, DK-8200 Aarhus N, Denmark - Author
Aarhus Universitetshospital - Author
European Fdn Study Chron Liver Failure EF Clif, Barcelona 08021, Spain - Author
European Foundation for the Study of Chronic Liver Failure (EF-CLIF) - Author
Goethe Univ Frankfurt, Dept Internal Med 1, Translat Hepatol, D-60323 Frankfurt, Germany - Author
Goethe-Universitat Frankfurt am Main - Author
Hosp Clin IDIBAPS, Dept Biochem & Mol Genet, Barcelona 08036, Spain - Author
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS - Author
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Abstract

Macrophages facilitate essential homeostatic functions e.g., endocytosis, phagocytosis, and signaling during inflammation, and express a variety of scavenger receptors including CD163 and CD206, which are upregulated in response to inflammation. In healthy individuals, soluble forms of CD163 and CD206 are constitutively shed from macrophages, however, during inflammation pathogen- and damage-associated stimuli induce this shedding. Activation of resident liver macrophages viz. Kupffer cells is part of the inflammatory cascade occurring in acute and chronic liver diseases. We here review the existing literature on sCD163 and sCD206 function and shedding, and potential as biomarkers in acute and chronic liver diseases with a particular focus on Acute-on-Chronic Liver Failure (ACLF). In multiple studies sCD163 and sCD206 are elevated in relation to liver disease severity and established as reliable predictors of morbidity and mortality. However, differences in expression- and shedding-stimuli for CD163 and CD206 may explain dissimilarities in prognostic utility in patients with acute decompensation of cirrhosis and ACLF.

Keywords

aclfacute decompensation of cirrhosisacute-on-chronic liver failurechronic hepatitis-cchronic liver diseasecysteine-rich domaindecompensated cirrhosisendothelial-cellsin-situinflammationliver cirrhosisliver cirrhosis, acute-on-chronic liver failuremacrophagenecrosis-factor-alphaphysiological rolespredict mortalityrecognitionscavenger receptorscd163scd206AclfAcute decompensation of cirrhosisAcute-on-chronic liver failureChronic hepatitis-cChronic liver diseaseCysteine-rich domainDecompensated cirrhosisEndothelial-cellsIn-situInflammationLiver cirrhosisLiver cirrhosis, acute-on-chronic liver failureMacrophageNecrosis-factor-alphaPhysiological rolesPredict mortalityRecognitionScavenger receptorScd163Scd206Soluble mannose receptor

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Cells due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 3. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 7.37 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 23.24 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-13, the following number of citations:

  • WoS: 103
  • Scopus: 126
  • Europe PMC: 49
  • OpenCitations: 112

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-13:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 163.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 163 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 5.45.
  • The number of mentions on the social network X (formerly Twitter): 9 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Denmark; Germany.