title: Changes in intestinal microflora in patients with chronic severe hepatitis.
abstract: OBJECTIVE
  To investigate changes in intestinal microflora in patients with chronic severe hepatitis (CSH), and their role in this life-threatening disease.
  
  
  METHODS
  We classified nineteen patients with chronic severe hepatitis as the CSH group, thirty patients with chronic hepatitis (CH) as the CH group and thirty-one healthy volunteer as the control group. Fecal flora from all subjects were analyzed. Concentrations of plasma endotoxin, serum cytokines tumor necrosis factor alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) and liver function were assessed.
  
  
  RESULTS
  The number of fecal bifidobacterium (P < 0.001, P < 0.05 respectively), as well as bacteroidaceae (P < 0.001, P < 0.01 respectively) were significantly deceased in patients with chronic severe hepatitis compared with the CH and control groups, while the number of enterobacteriaceae (P < 0.001, P < 0.05 respectively) and yeasts (P < 0.01, P < 0.05 respectively) were significantly increased. Levels of plasma endotoxin, serum TNF-alpha, IL-1 beta and total bilirubin (TBiL) were significantly increased in the CSH group. The concentration of endotoxin positively correlated with levels of both TNF-alpha, IL-1 beta and TBiL (P < 0.001, respectively). Levels of plasma endotoxin were positively correlated with the number of fecal enterobacteriaceae and negatively correlated with bifidobacterium (P < 0.05, P < 0.001, respectively).
  
  
  CONCLUSIONS
  Intestinal flora in patients with chronic severe hepatitis were severely disturbed and gut microbiological colonization resistance was impaired. Changes in intestinal flora may have a pivotal role in both the elevation of plasma endotoxin and further hepatic lesions resulting in liver failure.
authors.affiliation: Department of Infectious Deseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China. LJLi@mail.hz.zj.cn
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: Z
authors.initials: Z
authors.lastname: Wu
authors.forename: W
authors.initials: W
authors.lastname: Ma
authors.forename: Y
authors.initials: Y
authors.lastname: Yu
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D001644:Bifidobacterium / Q000302:isolation & purification; D001663:Bilirubin / Q000097:blood; D016207:Cytokines / Q000097:blood; D004731:Endotoxins / Q000097:blood; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006505:Hepatitis / Q000382:microbiology*; D006521:Hepatitis, Chronic / Q000382:microbiology*; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D008297:Male; D008875:Middle Aged
chemical_list: D016207:Cytokines; D004731:Endotoxins; D001663:Bilirubin