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Treatment with non‐selective beta‐blockers affects the systemic inflammatory response to bacterial DNA in patients with cirrhosis
Author(s) -
Gimenez Paula,
GarciaMartinez Irma,
Francés Rubén,
GonzalezNavajas Jose M.,
Mauri Montserrat,
Alfayate Rocío,
Almenara Susana,
Miralles Cayetano,
Palazon Jose M.,
Carnicer Fernando,
Pascual Sonia,
Such José,
Horga José F.,
Zapater Pedro
Publication year - 2018
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.13890
Subject(s) - cirrhosis , medicine , beta (programming language) , immunology , beta blocker , gastroenterology , heart failure , computer science , programming language
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 .