Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites.
OBJECTIVE
To determine intestinal permeability, the serum tumor necrosis factor (TNF)-alpha level and urine nitric oxide (NO) metabolites are altered in liver cirrhosis (LC) with or without ascites.


METHODS
Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol (PEG) 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-alpha concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay (ELISA) and Greiss reaction method, respectively.


RESULTS
The intestinal permeability index was significantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites (0.88 +/- 0.12 vs 0.52 +/- 0.05 or 0.53 +/- 0.03, P < 0.05) and correlated with urine nitrite excretion (r = 0.98). Interestingly, the serum TNF-alpha concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites (198.9 +/- 55.8 pg/mL vs 40.9 +/- 12.3 pg/mL or 32.1 +/- 13.3 pg/mL, P < 0.05). Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites (1170.9 +/- 28.7 micromol/L vs 903.1 +/- 55.1 micromol/L or 956.7 +/- 47.7 micromol/L, P < 0.05).


CONCLUSIONS
Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-alpha concentration was not related to LC with ascites.
Lee
Soong
S
Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
Son
Seung-Cheol
SC
Han
Moon-Jong
MJ
Kim
Woo-Jin
WJ
Kim
Soo-Hyun
SH
Kim
Hye-Ran
HR
Jeon
Woo-Kyu
WK
Park
Ki-Hong
KH
Shin
Myung-Geun
MG
D000328:Adult; D001201:Ascites / Q000378:metabolism / Q000503:physiopathology; D016022:Case-Control Studies; D002463:Cell Membrane Permeability / Q000502:physiology*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D008103:Liver Cirrhosis / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000652:urine; D009573:Nitrites / Q000652:urine*; D011092:Polyethylene Glycols / Q000378:metabolism / Q000493:pharmacokinetics*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D009573:Nitrites; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D011092:Polyethylene Glycols