Endotoxin and its binding proteins in chronic liver disease: the effect of transjugular intrahepatic portosystemic shunting

Wiley - Tập 22 Số 5 - Trang 380-387 - 2002
Arthur Kaser1, Othmar Ludwiczek1, Peter Waldenberger2, Werner Jaschke2, Wolfgang Vogel1, Herbert Tilg1
1Division of Gastroenterology and Hepatology, Department of Medicine, and
2Department of Radiology, University Hospital Innsbruck, Austria, Anichstr 35, 6020 Innsbruck, Austria

Tóm tắt

Abstract: Background: Gut‐derived endotoxin is insufficiently cleared by the diseased liver, and thus, is elevated in plasma of patients with chronic liver disease (CLD). Endotoxin action might be modified by binding to soluble CD14 (sCD14) and lipopolysaccharide‐binding protein (LBP), both of which have not yet been sufficiently studied in CLD.Methods: Endotoxin, sCD14 and LBP have been determined in peripheral blood of 72 patients and 39 control subjects, and in portal and hepatic venous blood of 12 patients during transjugular intrahepatic portosystemic shunt (TIPS) implantation.Results: Peripheral endotoxin (average 3‐fold increased compared to controls), LBP, and sCD14 plasma levels were elevated in chronic liver disease irrespective of Child stage m, preserve/absence of cirrhosis or aetiology. LBP, and sCD14. Furthermore, endotoxin levels in the portal vein (38.1 ± 6.1 pg/ml) were only slightly elevated compared to the hepatic vein (29.2 ± 4.4 pg/ml), and peripheral endotoxin levels did not increase after TIPS.Conclusions: Decreased hepatocellular function rather than hepatic blood shunting might be responsible for endotoxemia. The elevation in LBP and sCD14 levels may be a consequence of endotoxemia.

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Wiley

Tập 22 Số 5

380-387

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