What’s new in the treatment of ascites and spontaneous bacterial peritonitis

Cárdenas, Andrés; Ginès, Pere

doi:10.1007/s11894-008-0003-1

Cited by 9 publications

(6 citation statements)

References 68 publications

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“…Additionally, miR-125b expression in macrophages might be the results of complex opposing effects in patients with cirrhosis, who usually have elevated LPS levels26, because first exposure to LPS down-regulates miR-125b in macrophages1727, but re-stimulation to LPS up-regulates miR-125b expression, linking miR-125b to LPS tolerance17. SBP is a trigger for the development of renal failure2829, as well as circulatory and inflammatory changes are preceding the development of organ failure in context of acute-on-chronic liver failure30, although the exact mechanism is not fully understood. MiR-125b might be one of the mediators, which might be linked to kidney dysfunction in the situation of bacterial translocation.…”

Section: Discussionmentioning

confidence: 99%

MicroRNA-155 is upregulated in ascites in patients with spontaneous bacterial peritonitis

Lutz

Haimid

Pohlmann

et al. 2017

Sci Rep

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MircoRNA’s (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR’s were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up. 76 specimens from 72 patients were analysed. MiR’s were not associated to age, sex or aetiology of cirrhosis. MiR-125b levels differed between patients with low and high MELD score, and miR-125b levels showed an inverse correlation to serum creatinine (r2 = −0.23; p = 0.05). MiR-155 was elevated in patients with spontaneous bacterial peritonitis (SBP) (n = 10; p = 0.04). MiR-155 levels differed between patients with and without 30-day survival (p = 0.02). No association of ascites levels of investigated miR’s to size of varices, episodes of gastrointestinal bleeding or hepatorenal syndrome was observed. While miR-125b levels in ascites seem to be associated with liver and renal dysfunction, miR-155 might be implicated in local immune response in SBP.

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Section: Discussionmentioning

confidence: 99%

MicroRNA-155 is upregulated in ascites in patients with spontaneous bacterial peritonitis

Lutz

Haimid

Pohlmann

et al. 2017

Sci Rep

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“…SBP develops from the translocation of bacteria from the intestine, and successful management with early diagnosis and treatment with proper prevention in patients of high risk are necessary [144, 145]. Culture-negative neutrocytic ascites is considered to be a variant of SBP.…”

Section: The Role Of Mesothelial Cells In the Pathophysiology Of Tmentioning

confidence: 99%

“…The embryonic regression of the peritoneum that induces the inflammatory response induced by PH also could favor the presence of active antimicrobial components as has been described in the amniotic fluid [161]. Thus, the resistance to infection of the ascites would be explained, with usual subtle clinical manifestations in cases of secondary bacterial peritonitis [144, 145]. …”

Section: The Role Of Mesothelial Cells In the Pathophysiology Of Tmentioning

confidence: 99%

The Interstitial Lymphatic Peritoneal Mesothelium Axis in Portal Hypertensive Ascites: When in Danger, Go Back to the Sea

Aller

Prieto

Argudo³

et al. 2010

International Journal of Inflammation

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Portal hypertension induces a splanchnic and systemic low-grade inflammatory response that could induce the expression of three phenotypes, named ischemia-reperfusion, leukocytic, and angiogenic phenotypes.During the splanchnic expression of these phenotypes, interstitial edema, increased lymph flow, and lymphangiogenesis are produced in the gastrointestinal tract. Associated liver disease increases intestinal bacterial translocation, splanchnic lymph flow, and induces ascites and hepatorenal syndrome. Extrahepatic cholestasis in the rat allows to study the worsening of the portal hypertensive syndrome when associated with chronic liver disease. The splanchnic interstitium, the mesenteric lymphatics, and the peritoneal mesothelium seem to create an inflammatory pathway that could have a key pathophysiological relevance in the production of the portal hypertension syndrome complications. The hypothetical comparison between the ascitic and the amniotic fluids allows for translational investigation. From a phylogenetic point of view, the ancestral mechanisms for amniotic fluid production were essential for animal survival out of the aquatic environment. However, their hypothetical appearance in the cirrhotic patient is considered pathological since ultimately they lead to ascites development. But, the adult human being would take advantage of the potential beneficial effects of this “amniotic-like fluid” to manage the interstitial fluids without adverse effects when chronic liver disease aggravates.

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“…Therapieziel ist die Linderung der durch Aszites bedingten Symptome [5]. Bettruhe und kochsalzarme Diät sind mit der noch verbliebenen Lebensqualität der Patienten abzuwägen [6].…”

Section: Aszitesunclassified