We read with interest the article by Vibert et al. 1 recently published in HEPATOLOGY. The authors described their single-center experience with liver transplantation for hepatocellular carcinoma (HCC) in human immunodeficiency virus (HIV)-positive patients (21 cases) and compared those patients to
Bacterial translocation (BT) in cirrhosis
β Scribed by Reiner Wiest; Guadalupe Garcia-Tsao
- Publisher
- John Wiley and Sons
- Year
- 2005
- Tongue
- English
- Weight
- 329 KB
- Volume
- 41
- Category
- Article
- ISSN
- 0270-9139
No coin nor oath required. For personal study only.
β¦ Synopsis
Gut flora and bacterial translocation (BT) play an important role in the pathogenesis of the complications of cirrhosis. Research on the pathogenesis of BT and its clinical significance transcends established boundaries between microbiology, cell biology, intestinal pathophysiology, and immunology. This review delineates multiple mechanisms involved in the process of BT, with an emphasis on alterations in intestinal flora and mucosal barrier function, particularly immunological defense mechanisms. Current knowledge on the innate and adaptive immune response that allows a "friendly" communication between bacteria and host is summarized, and alterations occurring in cirrhosis that may facilitate BT are discussed. In addition, definition of a "pathological" BT is proposed together with an analysis of the anatomical site and route of BT. Finally, therapeutic approaches for the prevention of BT in experimental and human cirrhosis are reviewed. Future research in the field of BT in cirrhosis will allow the development of new therapeutic targets in the prevention of infections and other complications of cirrhosis.
π SIMILAR VOLUMES
Samples of peripheral and portal blood as well as ascitic fluid were Supported by a grant of the FISss (NΠ 91/0675) of the Spanish National Institute of cultured by immediate inoculation into blood culture bottles (Bactec Health.
I can hardly share the passionate enthusiasm of Breuhahn et al. for the ''dramatic'' improvements in understanding of molecular pathogenesis of hepatocellular carcinoma (HCC) and the claim for ''further rationally designed clinical trials based on molecular evidence''. 1 Among the causes of HCC, the
Bacterial DNA (bactDNA) is present in blood and ascitic fluid (AF) in a third of patients with cirrhosis and ascites, but whether this phenomenon represents episodes of bacterial translocation (BT), strictly considered when culture of mesenteric lymph nodes (MLNs) are positive, remains unknown. This
Presence of bacterial DNA in noninfected patients with cirrhosis and ascites is associated with a marked inflammatory response including activation of the inducible form of nitric oxide synthase and release of nitric oxide, similar to that observed in patients with spontaneous bacterial peritonitis.