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Background & Aims  The use of non‐selective beta‐blockers has been associated with lower rates of infection and reduced infection‐associated morbidity in patients with cirrhosis. However, it is unknown if these drugs modify the systemic inflammatory response to circulating bacterial  DNA .    Methods  Sixty‐three patients with cirrhosis were included during an episode of decompensation by ascites. Thirty of those patients were on beta‐blockers. Blood samples were obtained after each patient had been in the supine position for at least 30 minutes in a quiet atmosphere. Bacterial  DNA , serum cytokines, nitric oxide, and  LPS  were determined. Phagocytic and oxidative burst activities were determined in polymorphonuclear cells from the patients.    Results  The detection rate of bacterial  DNA  in the blood was the same (33%) for patients not treated and treated with non‐selective beta‐blockers. Patients naive to non‐selective beta‐blockers showed significantly higher serum levels of  IL 6,  IFN ‐gamma and  IL 10 in response to the presence of bacterial  DNA . Patients treated with non‐selective beta‐blockers showed higher basal inflammatory activity that did not change with the presence of bacterial  DNA . Monocytes and granulocytes from patients treated with non‐selective beta‐blockers showed a significantly increased phagocytic capacity in the presence of bacterial  DNA .    Conclusions  In patients with cirrhosis, chronic treatment with beta‐blockers is associated with a higher unstimulated production of serum cytokines and an increased phagocytic activity in the presence of bacterial  DNA .

Treatment with non‐selective beta‐blockers affects the systemic inflammatory response to bacterial DNA in patients with cirrhosis