Intestinal permeability in patients with chronic liver diseases: Its relationship with the aetiology and the entity of liver damage.
BACKGROUND
Alteration in intestinal permeability may be an important factor in the pathogenesis of both the progression of some chronic liver diseases and the onset of some complications in patients with liver cirrhosis.


OBJECTIVE
To investigate the relationships between intestinal permeability, portal hypertension, alcohol use, plasma levels of pro-inflammatory cytokines, and nitric oxide, expressed as s-nitrosothiols, and nitrite levels in patients with various types and degrees of chronic liver diseases.


METHODS
134 healthy volunteers and 83 patients with chronic liver damage entered the study. Intestinal permeability was assessed with the lactulose/mannitol test. Plasma levels of tumour necrosis factor-alpha, interleukin-6, and nitrite and total s-nitrosothiols were determined.


RESULTS
Intestinal permeability was altered in patients with advanced liver disease and impaired in 15-35% of patients without cirrhosis. Independent factors for intestinal permeability alteration were age, portal hypertension, alcohol use, and diabetes. Plasma levels of inflammatory cytokines and nitrosothiols were significantly higher in patients with altered intestinal permeability.


CONCLUSIONS
An intestinal permeability evaluation in patients with chronic liver diseases might clarify the significance of intestinal permeability in the pathophysiology of both the progression of liver damage, and the occurrence of complications that accompany liver cirrhosis.
Cariello
Rita
R
Department of Experimental Medicine, Second University of Naples, Italy.
Federico
Alessandro
A
Sapone
Anna
A
Tuccillo
Concetta
C
Scialdone
Valeria Rita
VR
Tiso
Angelo
A
Miranda
Agnese
A
Portincasa
Piero
P
Carbonara
Veronica
V
Palasciano
Giuseppe
G
Martorelli
Luigi
L
Esposito
Pasquale
P
Cartenì
Maria
M
Del Vecchio Blanco
Camillo
C
Loguercio
Carmela
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D048909:Diabetes Complications; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood; D007408:Intestinal Absorption / Q000502:physiology*; D007792:Lactulose; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D009573:Nitrites / Q000097:blood; D026403:S-Nitrosothiols / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D009573:Nitrites; D026403:S-Nitrosothiols; D014409:Tumor Necrosis Factor-alpha; D008353:Mannitol; D007792:Lactulose