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Endotoxin levels measured by a chromogenic assay in portal, hepatic and peripheral venous blood in patients with cirrhosis

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Lumsden, Alan B., Henderson, Michael J., Kutner, Michael H.·1988·Hepatology

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Abstract

Endotoxin concentrations were measured in the portal, hepatic and peripheral venous blood of two groups of patients with cirrhosis using a limulus-based chromogenic assay. The high sensitivity of chromogenic detection allowed measurement of endotoxin as low as 10 to 15 pg per ml, an order of magnitude greater than previously possible by gelation studies. Group 1 consisted of 56 patients with cirrhosis undergoing angiographic evaluation. In this group, there was wide variability in hepatic venous concentration [ 73 ± 110 pg per ml (mean ± S.D.)] and peripheral venous concentration [31 ± 58 pg per ml]. However, paired t test showed peripheral venous concentration was significantly (p < 0.001) lower than hepatic venous concentration. Neither hepatic or peripheral venous endotoxin levels correlated significantly with a variety of clinical, biochemical or radiological parameters. Group 2 consisted of 21 patients with cirrhosis undergoing shunt surgery. Endotoxin levels again showed a wide range, with portal venous concentration (142 ± 167 pg per ml) and simultaneous peripheral venous concentration (82 ± 150 pg per ml). Paired t test in this group showed a significant (p < 0.001) portal to peripheral venous gradient. This study showed the feasibility of measuring endotoxin in plasma to low concentrations by a chromogenic assay technique. It supports the concept of relatively high levels of endotoxin in the portal circulation. In the presence of liver disease, systemic endotoxemia occurs, which is augmented by stressful situations.

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Authors: Lumsden, A. B., Henderson, M. J., & Kutner, M. H.
Affiliations: Emory University (US)
ORCID: Lumsden, Alan B.
Kutner, Michael H.
Venue: Hepatology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1988-03
Volume: 8
Issue: 2
Pages: 232-236
ISSN: 0270-9139 (ISSN-L)
DOI: 10.1002/hep.1840080207
OpenAlex: W1972486471
Cited by: 427
References: 43
Citations by year: 2026: 1 · 2025: 8 · 2024: 4 · 2023: 11 · 2022: 10 · 2021: 8 · 2020: 12 · 2019: 7 · 2018: 11 · 2017: 11 · 2016: 19 · 2015: 15 · 2014: 8 · 2013: 11 · 2012: 14
FWCI: 8.24
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 10045 d)
Locations: Hepatology (publishedVersion)
PubMed (publishedVersion)
Funders: National Center for Research Resources (5M01 RR 00039, M01RR000039)
Topics: Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords: endotoxin, liver cirrhosis, portal blood, hepatic venous blood, peripheral venous blood
MeSH terms: Chromogenic Compounds, Endotoxins, Escherichia coli, Esophageal and Gastric Varices, Hemorrhage, Humans, Intraoperative Period, Liver Circulation, Liver Cirrhosis, Osmolar Concentration, Postoperative Period, Veins

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Endotoxin levels measured by a chromogenic assay in portal, hepatic and peripheral venous blood in patients with cirrhosis

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