Abstract

FERRO, Susana Mão de et al. Intestinal Permealibity in Patients with Liver Cirrhosis: Correlation with Endotoxemia and Circulating Levels of TNFα, IL - 1 and IL - 6. J Port Gastrenterol. [online]. 2011, vol.18, n.2, pp.66-72. ISSN 0872-8178.

INTRODUCTION: Increased intestinal permeability (IP) may contribute to the pathogenesis of liver cirrhosis (LC), allowing for an increase in bacterial translocation and endotoxemia, with subsequent rise in inflammatory mediators. AIMS: To evaluate IP in patients with LC and its correlation with endotoxemia, cytokine response, and risk of complications. METHODS: 19 patients with LC, without active alcohol consumption, and 19 controls, without evidence of LC. IP was evaluated with the lactulose-manitol test (Lac-Man), and serum levels of endotoxaemia, IL - 1, IL - 6, and TNFα. RESULTS: Intestinal permeability: LAC/MAN: 0.16 ± 0.11 vs 0.40 ± 0.38, p=0.02, and endotoxaemia: 0.38 ± 0.29 vs 0.28 ± 0.15 EU/mL, ns, in patients and controls respectively, suggesting increased permeability in both groups. PI did not correlate with endotoxinemia and individuals with oesophageal varices did not present increased intestinal permeability. IL - 1: 2.3 ± 0.3 vs. 1.8 ± 0.4 pg/mL, p = 0.03, IL - 6: 4.1 ± 3.4 vs. 1.9 ± 2.2 pg/mL, p = 0.01; TNFα: 6.2 ± 2.1 vs. 3.7 ± 3.7 pg /mL, p = 0.001, in patients and controls respectively. CONCLUSIONS: In compensated liver cirrhosis, intestinal permeability and endotoxaemia are increased, with no correlation with the presence of portal hypertension, although with a significant increase in circulating cytokines which did not correlate with the degree of intestinal permeability or endotoxaemia.

Keywords : Liver cirrhosis; intestinal permeability; endotoxaemia.

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