Endotoxemia in a Series of 104 Patients with Chronic Liver Diseases: Prevalence and Significance

Abstract

Endotoxemia, measured by Limulus amebocyte lysate (LAL) assay, was found to be present in 34 (46%) out of 72 patients with liver cirrhosis and in 7 (22%) out of 32 patients with chronic active hepatitis (CAH). In cirrhotics, no difference in the alteration of liver function tests and renal function was found between the two groups. However, 18 months mortality was higher in the group with endotoxemia in respect to the group without endotoxemia (p < 0.05). In CAH patients, the Limulus-positive group showed a higher level of serum γ-globulins, compared to the Limulus-negative group (p < 0.005). Moreover, CAH patients with a positive LAL test showed marked histological activity and bridging necrosis more frequently than those with a negative test. This suggests that in these patients the appearance of endotoxemia may indicate a more advanced stage of the disease.

Effects of lactitol on intestinal microflora and plasma endotoxin in patients with chronic viral hepatitis

“…Many studies revealed that the subsequently changes such as the overgrowth of gram negative bacteria, the decline of intestinal bacterial CR and the lack of bile salt can enlarge the pool of endotoxin and increase the permeability of the intestinal mucosa in the intestine of CH patients. 3,19 Thus, the absorption of endotoxin from the intestine is increased, meanwhile the function of hepatic Kupffer cells is disturbed and the peripheral blood's capacity for endotoxin clearance is reduced in CVH, hence the induction of the gut-derived endotoxemia. 2 Lactitol is a synthetic disaccharide of galactose and sorbitol.…”

Endotoxemia in Patients on Hemodialysis

“…In the present study the diagnosis of endotoxemia was based on the EST values, and 6 out of 87 patients had pathological endo toxemia. The high endotoxin levels in 5 patients appear related to either liver cirrhosis or infection, since endo toxin can frequently be detected in the systemic circula tion of patients with cirrhosis [17] as well as infection. In addition, the treatment of these complications reduced the high endotoxin levels.…”

Circulating sCD14 Is Associated with Virological Response to Pegylated-Interferon-Alpha/Ribavirin Treatment in HIV/HCV Co-Infected Patients

“…Subjects with HCV mono-infection display a high degree of microbial translocation (MT) and elevated LPS levels are strongly associated with the severity of liver disease [27], [28]; likewise, augmented plasma LPS also features non-alcoholic fatty liver disease [29]–[31]. Furthermore, in animal models LPS appears to accelerate liver fibrosis, both directly by increasing hepatic fibrosis and stimulating liver Kupffer cells, and indirectly by enhancing immune activation [32], [33].…”