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Effect of propranolol on the factors promoting bacterial translocation in cirrhotic rats with ascites
Abstract
Bacterial translocation appears to be an important mechanism in the pathogenesis of spontaneous infections in cirrhosis. Cirrhotic patients are commonly treated with β-adrenoceptor blockers, but the impact of this treatment in the factors promoting bacterial translocation has not been investigated. This study was aimed at investigating in cirrhotic rats with ascites the effect of propranolol on intestinal bacterial load, transit, and permeability of the bowel and on the rate of bacterial translocation. Bacterial translocation to mesenteric lymph nodes and intestinal bacterial overgrowth, permeability (urinary excretion of 99m Tc-diethylenetriaminepentaacetic acid [99m Tc-DTPA]), and transit (geometric center ratio of 51 Cr) were assessed in 29 rats with carbon tetrachloride (CCl 4) cirrhosis and 20 controls. These variables were then measured in 12 placebo- and in 13 propranolol-treated ascitic cirrhotic rats. Bacterial translocation was present in 48% of the cirrhotic rats and in none of the controls. Cirrhotic rats with intestinal bacterial overgrowth had a significantly higher rate of translocation and slower intestinal transit than those without it. Among the 15 rats with overgrowth and a 99m Tc-DTPA excretion greater than 10%, 15 had translocation and 2 had bacterial peritonitis. Only 1 of the 14 rats with either intestinal overgrowth or a 99m Tc-DTPA excretion greater than 10% presented translocation. Compared with the placebo group, propranolol-treated animals had significantly lower portal pressure, faster intestinal transit, and lower rates of bacterial overgrowth and translocation. In ascitic cirrhotic rats, bacterial translocation results from intestinal overgrowth and severe damage to gut permeability. In this setting, intestinal overgrowth is associated with intestinal hypomotility. Propranolol accelerates the intestinal transit, decreasing the rates of bacterial overgrowth and translocation.
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“Accordingly, nonselective β-adrenergic blockers decrease intestinal transit time and reduce intestinal bacterial overgrowth, intestinal permeability and bacterial translocation in experimental models of cirrhosis as well as in patients153–157.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [153]
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Balogh, B., Tornai, D., Csillag, A., Tornai, I., Vitális, Z., Kovats, P. J., Antal‐Szalmás, P., Dinya, T., Laleman, W., Coenraad, M. J., et al. (2025) · Liver International · doi:10.1111/liv.70350 · Cited by 8
Anam, A. K., Karia, K., Jesudian, A. B., & Bosworth, B. P. (2016) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2016.08.009 · Cited by 8
Taprantzi, D. (2017) · Annals of Gastroenterology · doi:10.20524/aog.2017.0222 · Cited by 8
Swift, O., Vilar, E., & Farrington, K. (2019) · Seminars in Dialysis · doi:10.1111/sdi.12810 · Cited by 8
Jeyaraman, N., Jeyaraman, M., Mariappan, T., Muthu, S., Ramasubramanian, S., Sharma, S., Santos, G. S., da Fonseca, L. F., & Lana, J. F. (2024) · World Journal of Gastrointestinal Pharmacology and Therapeutics · doi:10.4292/wjgpt.v15.i6.98146 · Cited by 7
Santopaolo, F., Coppola, G., Giuli, L., Gasbarrini, A., & Ponziani, F. R. (2022) · Microbiology Research · doi:10.3390/microbiolres13030038 · Cited by 8
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Markers of immunity and bacterial translocation in cirrhosis.
Mortensen, C. (2015) · PubMed · Cited by 7
García–Tsao, G. (2001) · Current Opinion in Gastroenterology · doi:10.1097/00001574-200105000-00012 · Cited by 7
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Is this really the end of beta-blockers in patients with cirrhosis and refractory ascites?
Thévenot, T., Cervoni, J., Monnet, É., Sheppard, F., & Martino, V. D. (2010) · Hepatology · doi:10.1002/hep.23839 · Cited by 7
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Metadata
- Authors
- Pérez-Paramo, M., Muñoz, J., Albillos, A., Freile, I., Portero, F., Santos, M., & Ortiz-Berrocal, J.
- Venue
- Hepatology
- Published
- 2000-01
- Volume
- 31
- Issue
- 1
- Pages
- 43-48
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2003357282
- Cited by
- 271
- References
- 25
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 12 · 2023: 7 · 2022: 11 · 2021: 5 · 2020: 11 · 2019: 16 · 2018: 13 · 2017: 11 · 2016: 19 · 2015: 13 · 2014: 12 · 2013: 11 · 2012: 16
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fondo de Investigaciones Sanitarias (99/0356)
- Universidad de Alcalá (E001/98 y E002/99)
- Programa Nacional de Salud from the Comisión Interministerial de Ciencia y Tecnología
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- propranolol, bacterial translocation, liver cirrhosis, ascites, beta-blockers, intestinal bacterial overgrowth, intestinal transit, intestinal permeability, portal hypertension, spontaneous bacterial peritonitis, mesenteric lymph nodes
- MeSH terms
- Animals, Bacteria, Carbon Tetrachloride, Intestinal Absorption, Intestines, Liver Cirrhosis, Experimental, Lymph Nodes, Male, Mesentery, Propranolol, Technetium Tc 99m Pentetate, Rats, Sprague-Dawley, Bacterial Translocation, Rats
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