title: Changes in gut bacterial populations and their translocation into liver and ascites in alcoholic liver cirrhotics.
abstract: BACKGROUND
  The liver is the first line of defence against continuously occurring influx of microbial-derived products and bacteria from the gut. Intestinal bacteria have been implicated in the pathogenesis of alcoholic liver cirrhosis. Escape of intestinal bacteria into the ascites is involved in the pathogenesis of spontaneous bacterial peritonitis, which is a common complication of liver cirrhosis. The association between faecal bacterial populations and alcoholic liver cirrhosis has not been resolved.
  
  
  METHODS
  Relative ratios of major commensal bacterial communities (Bacteroides spp., Bifidobacterium spp., Clostridium leptum group, Enterobactericaea and Lactobacillus spp.) were determined in faecal samples from post mortem examinations performed on 42 males, including cirrhotic alcoholics (n = 13), non-cirrhotic alcoholics (n = 15), non-alcoholic controls (n = 14) and in 7 healthy male volunteers using real-time quantitative PCR (RT-qPCR). Translocation of bacteria into liver in the autopsy cases and into the ascites of 12 volunteers with liver cirrhosis was also studied with RT-qPCR. CD14 immunostaining was performed for the autopsy liver samples.
  
  
  RESULTS
  Relative ratios of faecal bacteria in autopsy controls were comparable to those of healthy volunteers. Cirrhotics had in median 27 times more bacterial DNA of Enterobactericaea in faeces compared to the healthy volunteers (p = 0.011). Enterobactericaea were also the most common bacteria translocated into cirrhotic liver, although there were no statistically significant differences between the study groups. Of the ascites samples from the volunteers with liver cirrhosis, 50% contained bacterial DNA from Enterobactericaea, Clostridium leptum group or Lactobacillus spp.. The total bacterial DNA in autopsy liver was associated with the percentage of CD14 expression (p = 0.045). CD14 expression percentage in cirrhotics was significantly higher than in the autopsy controls (p = 0.004).
  
  
  CONCLUSIONS
  Our results suggest that translocation of intestinal bacteria into liver may be involved as a one factor in the pathogenesis of alcoholic liver cirrhosis.
authors.affiliation: Department of Forensic Medicine, University of Tampere, School of Medicine, Medisiinarinkatu 3, 33014 Tampere, Finland. Sari.Tuomisto@uta.fi.
authors.forename: Sari
authors.initials: S
authors.lastname: Tuomisto
authors.forename: Tanja
authors.initials: T
authors.lastname: Pessi
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Risto
authors.initials: R
authors.lastname: Vuento
authors.forename: Janne
authors.initials: J
authors.lastname: Aittoniemi
authors.forename: Pekka J
authors.initials: PJ
authors.lastname: Karhunen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000382:microbiology; D001201:Ascites / Q000382:microbiology*; D018988:Bacterial Translocation; D001439:Bacteroides / Q000235:genetics / Q000302:isolation & purification; D001644:Bifidobacterium / Q000235:genetics / Q000302:isolation & purification; D016022:Case-Control Studies; D003013:Clostridium / Q000235:genetics / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D004755:Enterobacteriaceae / Q000235:genetics / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology*; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007778:Lactobacillus / Q000235:genetics / Q000302:isolation & purification; D018950:Lipopolysaccharide Receptors / Q000032:analysis; D008099:Liver / Q000737:chemistry / Q000382:microbiology*; D008104:Liver Cirrhosis, Alcoholic / Q000382:microbiology*; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D018950:Lipopolysaccharide Receptors