Small bowel bacterial overgrowth and endotoxemia in cirrhosis.
OBJECTIVE
To investigate the incidence of the small bowel bacterial overgrowth in cirrhotics and analyze the correlation among small bowel bacterial overgrowth (SBBO), plasma endotoxin level and plasma interleukin-2(IL-2), interleukin-6(IL-6), or tumor necrosis factor alpha(TNF-alpha) level.


METHODS
Small bowel bacterial overgrowth in 71 cirrhotics was test by glucose hydrogen breath test (GHBT); plasma endotoxin in cirrhotics was measured with limilus lysate test; and plasma cytokine (IL-2, IL-6 and TNF-alpha) was measured with a solid-phase enzyme-linked immunosorbent assay; the incidence of SBBO in those 71 cirrhotics was investigated and the correlation between plasma endotoxin level and plasma IL-2, IL-6, or TNF-alpha level was analysed.


RESULTS
(1)Positive GHBT were observed in 18 of 71 icrrhotics(25.3%); (2) Plasma endotoxin, IL-2, IL-6 and TNF-alpha levels were significantly higher in those cirrhotic patients with positive GHBT than in those with negative GHBT [(0.715 +/- 0.229) Eu/L versus (0.379 +/- 0.223) Eu/L, (19.15 +/- 4.60) ng/L versus (9.41 +/- 6.69) ng/L, (93.29 +/- 27.37) ng/L versus (53.22 +/- 28.31) ng/L, (42.18 +/- 16.91) ng/L versus (27.72 +/- 17.06) ng/L, respectively; P < 0.01]; (3) A significant correlation was observed between the level of plasma endotoxin and the level of plasma IL-2(r = 0.894, P < 0.001), IL-6(r  = 0.857,  P < 0.001) or TNF-alpha(  r  = 0.845,P < 0.001)in cirrhotics;


CONCLUSIONS
(1)Plasma endotoxin, IL-2, IL-6,and TNF-alpha levels are increased in cirrhotic patients with SBBO, which suggests SBBO in cirrhotics may exasperated endotoxeamia;(2)Plasma endotoxin level in cirrhotics may stimulate some kinds of immune activated cells to produce IL-2, IL-6 and TNF-alpha, which may deteriorated cirrhosis or the complications.
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510080, China.
Jinhui
J
Wang
Minhu
M
Chen
Guangyu
G
Sun
Et Al
D001424:Bacterial Infections; D019446:Endotoxemia; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha