title: Association of markers of bacterial translocation with immune activation in decompensated cirrhosis.
abstract: BACKGROUND
  Bacterial translocation (BT) may cause infections, in particular, spontaneous bacterial peritonitis (SBP). In the absence of overt infection, BT may further stimulate the immune system and contribute to haemodynamic alterations and complications. Bacterial DNA (bDNA) is claimed to be a promising surrogate marker for BT, although its clinical relevance has been questioned.
  
  
  METHODS
  In 38 cirrhotic patients with and without SBP, bDNA in blood and ascites were assessed by 16S rDNA quantitative PCR. Levels of lipopolysaccharide-binding protein in plasma and highly sensitive C-reactive protein, tumour necrosis factor-α, soluble urokinase plasminogen activating receptor, interleukin-6, interleukin 8, interferon-γ inducible protein-10 and vascular endothelial growth factor in plasma and ascites were measured by multiplex cytokine and ELISA assays.
  
  
  RESULTS
  In patients without signs of SBP or positive cultures, we found a high frequency of bDNA but low concordance of bDNA between blood and ascites. Markers of inflammation were not significantly different between blood bDNA-positive (22%), ascites bDNA-positive (52%), and bDNA-negative patients. The 16S rDNA PCR failed to show bDNA in two out of six samples with SBP. Sequencing of positive samples did not determine the source of bDNA.
  
  
  CONCLUSIONS
  bDNA as assessed by this PCR method was largely unrelated to markers of inflammation and does not seem to be of clinical value in the diagnosis of SBP. According to our results, bDNA is not a reliable marker of BT.
authors.affiliation: Departments of aGastroenterology bClinical Physiology and Nuclear Medicine, Centre of Functional Imaging and Research cCentre for Clinical Research, Hvidovre University Hospital, Hvidovre dMycoplasma Laboratory, Microbiology and Infection Control, Statens Serum Institut eDepartment of Internal Medicine I, Bispebjerg Hospital fDepartment of Internal Medicine, Glostrup Hospital, Glostrup gDepartment of Medicine, Svendborg Sygehus, Svendborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Mortensen
authors.forename: Jørgen Skov
authors.initials: JS
authors.lastname: Jensen
authors.forename: Lise
authors.initials: L
authors.lastname: Hobolth
authors.forename: Sanne
authors.initials: S
authors.lastname: Dam-Larsen
authors.forename: Bjørn S
authors.initials: BS
authors.lastname: Madsen
authors.forename: Ove
authors.initials: O
authors.lastname: Andersen
authors.forename: Søren
authors.initials: S
authors.lastname: Møller
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
mesh_terms: D001201:Ascites / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D001202:Ascitic Fluid / Q000276:immunology / Q000382:microbiology; D001419:Bacteria / Q000145:classification / Q000235:genetics*; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D018988:Bacterial Translocation; D015415:Biomarkers / Q000097:blood; D004269:DNA, Bacterial / Q000097:blood / Q000235:genetics*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009664:Norway; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000097:blood / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D015203:Reproducibility of Results; D021521:Ribotyping / Q000379:methods
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial; D018836:Inflammation Mediators; D012336:RNA, Ribosomal, 16S