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Circulating levels of 3‐hydroxymyristate, a direct quantification of endotoxaemia in noninfected cirrhotic patients
Author(s) -
Weil Delphine,
Pais de Barros JeanPaul,
Mourey Guillaume,
Laheurte Caroline,
Cypriani Benoit,
Badet Nicolas,
Delabrousse Eric,
Grandclément Emilie,
Di Martino Vincent,
Saas Philippe,
Lagrost Laurent,
Thévenot Thierry
Publication year - 2019
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.13916
Subject(s) - gastroenterology , medicine , alcoholic hepatitis , cirrhosis , endocrinology , alcoholic liver disease
Background & Aims The quantification of lipopolysaccharide ( LPS ) in biological fluids is challenging. We aimed to measure plasma LPS concentration using a new method of direct quantification of 3‐hydroxymyristate (3‐ HM ), a lipid component of LPS , and to evaluate correlations between 3‐ HM and markers of liver function, endothelial activation, portal hypertension and enterocyte damage. Methods Plasma from 90 noninfected cirrhotic patients (30 Child‐Pugh [ CP ]‐A, 30 CP ‐B, 30 CP ‐C) was prospectively collected. The concentration of 3‐ HM was determined by high‐performance liquid chromatography coupled with mass spectrometry. Results 3‐ HM levels were higher in CP ‐C patients ( CP ‐A/ CP ‐B/ CP ‐C: 68/70/103 ng/mL, P = 0.005). Patients with severe acute alcoholic hepatitis (n = 16; 113 vs 74 ng/mL, P = 0.012), diabetic patients (n = 22; 99 vs 70 ng/mL, P = 0.028) and those not receiving beta blockers (n = 44; 98 vs 72 ng/mL, P = 0.034) had higher levels of 3‐ HM . We observed a trend towards higher baseline levels of 3‐ HM in patients with hepatic encephalopathy (n = 7; 144 vs 76 ng/mL, P = 0.45) or SIRS (n = 10; 106 vs 75 ng/mL, P = 0.114). In multivariate analysis, high levels of 3‐ HM were associated with CP ( OR = 4.39; 95% CI = 1.79‐10.76) or MELD ( OR = 8.24; 95% CI = 3.19‐21.32) scores. Patients dying from liver insufficiency (n = 6) during a 12‐month follow‐up had higher baseline levels of 3‐ HM (106 vs 75 ng/mL, P = 0.089). Conclusions In noninfected cirrhotic patients, 3‐ HM arises more frequently with impairment of liver function, heavy alcohol consumption, diabetic status, nonuse of beta blockers and a trend towards poorer outcome is also observed. The direct mass measurement of LPS using 3‐ HM appears reliable to detect transient endotoxaemia and promising to manage the follow‐up of cirrhotic patients.