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Endotoxemia in patients with chronic liver diseases: relationship to severity of liver diseases, presence of esophaegeal varices, and hyperdynamic circulation.
Abstract
Plasma endotoxin levels were investigated using a quantitative Limulus assay in patients with chronic liver diseases and correlated with the severity of liver diseases, the presence of esophageal varices, and hemodynamic parameters. The plasma endotoxin levels were significantly higher in chronic hepatitis patients with acute exacerbation (10.1 +/- 1.3 pg/ml, n = 13, p < 0.05) and patients with cirrhosis (7.0 +/- 0.7 pg/ml, n = 126, p < 0.05) than in healthy subjects (2.9 +/- 0.2 pg/ml, n = 45). Chronic hepatitis patients (n = 30) had plasma endotoxin levels which were similar to those in healthy subjects (4.6 +/- 0.5 vs. 2.9 +/- 0.2 pg/ml, p > 0.05) but lower than those in chronic hepatitis patients with acute exacerbation (4.6 +/- 0.5 vs. 10.1 +/- 1.3 pg/ml, p < 0.05). Endotoxemia (plasma endotoxin level > 5.7 pg/ml) was found in 27%, 85% and 41% of patients with chronic hepatitis, chronic hepatitis with acute exacerbation, and cirrhosis, respectively. In patients with cirrhosis, the plasma endotoxin levels progressively increased in relation to the severity of liver dysfunction (Pugh's class A/B/C = 4.9 +/- 0.5/7.9 +/- 1.4/10.2 +/- 2.0 pg/ml, p < 0.05). In contrast, plasma endotoxin levels were comparable between patients with cirrhosis with and without esophageal varices (p > 0.05). Chronic hepatitis patients with acute exacerbation (no collaterization) had much higher plasma endotoxin levels than those in patients with cirrhosis and large varices (p < 0.05), whereas compensated patients with cirrhosis and large esophageal varices had plasma endotoxin levels similar to those seen in chronic hepatitis patients (no collaterization) (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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“Mean portal vein LPS levels increase in chronic liver injury from <3 pg/ml in healthy volunteers to 4.9 pg/ml, 7.9 pg/ml and 10.2 pg/ml in patients with Child–Turcotte-Pugh cirrhosis stage A, B and C, respectively24.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [24]
In the citing paper
“High circulating LPS levels in mice and patients with CLD as well as in HCC14,24,77,78 demonstrate the presence of a leaky gut during multiple stages of CLD and hepatocarcinogenesis (FIG. 1).”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [24]
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Metadata
- Authors
- Lin, R.-S., Lee, F.-Y., Lee, S.-D., Tsai, Y.-T., Lin, H. C., Rei-Hwa, L., Wan-Ching, H., Cheng-Chun, H., Sun-Sang, W., & Kwang-Juei, L.
- Affiliations
- Taipei Veterans General Hospital (TW)
- National Yang Ming University (TW)
- Corresponding author
- Lee, Fa-Yauh
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 1995-02
- Volume
- 22
- Issue
- 2
- Pages
- 165-172
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2155112010
- Cited by
- 355
- References
- 40
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 19 · 2022: 15 · 2021: 16 · 2020: 23 · 2019: 16 · 2018: 11 · 2017: 14 · 2016: 16 · 2015: 31 · 2014: 13 · 2013: 14 · 2012: 27
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- 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
- endotoxemia, plasma endotoxin, chronic liver disease, liver cirrhosis, chronic hepatitis, esophageal varices, hyperdynamic circulation, portal hypertension, acute exacerbation, liver dysfunction severity, collateral circulation
- MeSH terms
- Blood Circulation, Chronic Disease, Endotoxins, Esophageal and Gastric Varices, Female, Hepatitis, Humans, Liver Cirrhosis, Liver Diseases, Male, Middle Aged
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