Presence of bacterial-DNA in cirrhosis identifies a subgroup of patients with marked inflammatory response not related to endotoxin.
OBJECTIVE
Serum lipopolysaccharide-binding protein and bacterial-DNA have been proposed as markers of bacterial translocation and this study aimed to evaluate the immune response registered by bacterial-DNA from Gram-positive and Gram-negative microorganisms and the effect on lipopolysaccharide-binding protein, to further investigate both markers.


METHODS
Thirty-two patients were distributed into two groups according to the presence of bacterial-DNA, determined by broad-range PCR of 16SrRNA gene. Serum endotoxin, lipopolysaccharide-binding protein, cytokines and nitric oxide products were measured by ELISA.


RESULTS
Serum endotoxin and lipopolysaccharide-binding protein were non-significantly higher in patients with bacterial-DNA than in those without bacterial-DNA. Regarding patients with bacterial-DNA from Gram-positive microorganisms (n = 8), these levels were similar to those in patients without bacterial-DNA (n = 16), and significantly lower than in patients with bacterial-DNA from Gram-negative bacteria. Tumour necrosis factor-alpha and interleukin-6 were significantly increased in patients with vs without bacterial-DNA (324.93+/-70.76 vs 134.91+/-34.58microg/mL; p<0.05; 294.96+/-87.48 vs 175.92+/-60.58microg/mL, p < 0.05, respectively). Patients with bacterial-DNA from Gram-positive microorganisms also showed significantly higher levels for both cytokines than patients without bacterial-DNA, and similar to those in patients with bacterial-DNA from Gram-negative bacteria.


CONCLUSIONS
Patients with translocation of bacterial-DNA from Gram-positive microorganisms showed increased proinflammatory cytokines unrelated to endotoxin, which would not be detected by serum lipopolysaccharide-binding protein measurement.
González-Navajas
José M
JM
CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
Bellot
Pablo
P
Francés
Rubén
R
Zapater
Pedro
P
Muñoz
Carlos
C
García-Pagán
Juan Carlos
JC
Pascual
Sonia
S
Pérez-Mateo
Miguel
M
Bosch
Jaime
J
Such
José
J
D000209:Acute-Phase Proteins; D000368:Aged; D018988:Bacterial Translocation; D015415:Biomarkers; D002352:Carrier Proteins / Q000097:blood; D016207:Cytokines / Q000097:blood; D004269:DNA, Bacterial / Q000032:analysis*; D004731:Endotoxins / Q000633:toxicity*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006090:Gram-Negative Bacteria / Q000737:chemistry; D006094:Gram-Positive Bacteria / Q000737:chemistry; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000473:pathology*; D015850:Interleukin-6 / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood; D008099:Liver / Q000737:chemistry* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D015415:Biomarkers; D002352:Carrier Proteins; D016207:Cytokines; D004269:DNA, Bacterial; D004731:Endotoxins; D015850:Interleukin-6; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D009569:Nitric Oxide; D014409:Tumor Necrosis Factor-alpha; D000099231:Lipopolysaccharide-Binding Protein