Premium
Grade of soluble inflammatory response is mainly affected by circulating bacterial DNA concentrations in cirrhosis
Author(s) -
Caro Elena,
Francés Rubén,
Zapater Pedro,
Pascual Sonia,
Bellot Pablo,
Such José
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13118
Subject(s) - cirrhosis , nitric oxide , immune system , medicine , ascites , tumor necrosis factor alpha , lipopolysaccharide , interleukin , bacteria , immunology , endocrinology , cytokine , chemistry , biology , genetics
Background & Aims Patients with decompensated cirrhosis show a marked innate immune response that shows a wide variability. The reasons for this fact have not been previously evaluated. This investigation was undertaken to study factors influencing the immune response intensity in both serum and ascitic fluid in patients with cirrhosis and ascites with presence of bact DNA . Methods 77 patients with cirrhosis and presence of bact DNA fragments in blood and ascitic fluid were included. Identification of bact DNA was evaluated by 16Sr RNA gene PCR followed by nucleotide sequencing and by species‐specific PCR . Concentration of amplified bacterial‐ DNA , bacteria identification, LPS , TNF ‐alpha, IFN ‐gamma, Interleukin 12 and nitric oxide in serum and ascitic fluid were evaluated as factors related to intensity of the immune response. Results Serum and AF levels of bact DNA , TNF ‐α, IFN ‐γ and nitric oxide concentration were higher in patients with presence of bact DNA from gram negative bacteria. Serum TNF ‐α levels showed a significant correlation with concentrations of bact DNA ( r = 0.88; P = 0.001) and LPS ( r = 0.28; P = 0.016). Serum nitric oxide levels were also significantly correlated with concentrations of bact DNA ( r = 0.761; P = 0.001) but not with LPS levels. Levels of INF ‐γ and IL ‐12 were not significantly correlated with either bact DNA nor LPS levels. Plasmatic concentration of bact DNA was the most accurately correlated factor with the inflammatory response ( ancova model included only levels of bact DNA ( r 2 = 0.87, P = 0.047 for TNF ‐α; r 2 = 0.45, P = 0.03 for NO x). Conclusions Bacterial‐ DNA concentration is the most influencing variable associated with serum TNF ‐α and nitric oxide response.