It has been demonstrated that elevated circulating prostaglandin E2 (PGE2) levels contribute to immune suppression in AD patients.8 The plasma protein albumin binds and catalyses inactivation of PGE2.9 Albumin is synthesised in the liver and levels fall as the synthetic function of the liver declines in advanced cirrhosis, making PGE2 more bioavailable. The gene discussed is ALB; the disease is Cirrhosis.