Serum endotoxin and inflammatory mediators in patients with cirrhosis and hepatic encephalopathy
Abstract
Background Recent observations suggest that inflammatory response may be important in the pathogenesis of hepatic encephalopathy. The aim of the study was to measure arterial ammonia, tumour necrosis factor-alpha, Interleukin-6, Interleukin-18, and serum endotoxin levels and their correlation with different grades of hepatic encephalopathy.Methods 120 patients with cirrhosis were enrolled: 20 patients each of cirrhosis with grades I, II, III and IV hepatic encephalopathy, cirrhosis with and without minimal hepatic encephalopathy and healthy controls were tested for arterial ammonia, tumour necrosis factor-alpha, Interleukin-6, Interleukin-18 and serum endotoxin levels.Results Median arterial ammonia, tumour necrosis factor-alpha, Interleukin-6, Interleukin-18 and serum endotoxin levels were significantly higher in patient with hepatic encephalopathy and minimal hepatic encephalopathy as compared to patients without minimal hepatic encephalopathy and healthy controls. Arterial ammonia (r = 0.72, p = 0.03), tumour necrosis factor alpha (r = 0.87, p = 0.02), Interleukin-6 (r = 0.50, p = 0.05), Interleukin-18 (r = 0.76, p = 0.02) and serum endotoxin (r = 0.91, p = 0.01) correlated with higher grades of hepatic encephalopathy.Conclusion In hepatic encephalopathy arterial ammonia, inflammatory mediators, and serum endotoxin are elevated and correlate with encephalopathy grade.
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Blood cytokine levels correlate with hepatic encephalopathy.
“although blood endotoxin levels correlate with hepatic encephalopathy, so to do blood ammonia and cytokine levels, which are also potentially causal for the encephalopathy”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
Blood ammonia levels correlate with hepatic encephalopathy.
“although blood endotoxin levels correlate with hepatic encephalopathy, so to do blood ammonia and cytokine levels, which are also potentially causal for the encephalopathy”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
Blood endotoxin levels correlate with hepatic encephalopathy.
“blood endotoxin levels correlate with hepatic encephalopathy”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
It is still not known whether endotoxin causes hepatic encephalopathy.
“so we still do not know whether endotoxin causes hepatic encephalopathy [114]”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
About half of patients with cirrhosis will develop long-term cognitive deficits, called hepatic encephalopathy, progressing from forgetfulness and confusion to coma.
“About half of patients with cirrhosis will develop long-term cognitive deficits (called hepatic encephalopathy), progressing from forgetfulness and confusion to coma.”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
Blood ammonia and cytokine levels are also potentially causal for hepatic encephalopathy.
“which are also potentially causal for the encephalopathy”
From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [114]
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References 33 · Cited by 71
- Authors
- Jain, L., Sharma, B. C., Sharma, P., Srivastava, S., Agrawal, A., & Sarin, S. K.
- Affiliations
- Govind Ballabh Pant Hospital (IN)
- Institute of Liver and Biliary Sciences (IN)
- Corresponding author
- Sharma, Barjesh Chander
- Venue
- Digestive and Liver Disease
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 44
- Issue
- 12
- Pages
- 1027-1031
- ISSN
- 1590-8658 (ISSN-L)
- OpenAlex
- W2021582312
- Cited by
- 71
- References
- 33
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 5 · 2017: 1 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 5
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Digestive and Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- hepatic encephalopathy, liver cirrhosis, serum endotoxin, arterial ammonia, TNF-α, interleukin-6, IL-18, inflammatory mediators, minimal hepatic encephalopathy, encephalopathy severity
- MeSH terms
- Adolescent, Adult, Aged, Ammonia, Endotoxins, Female, Hepatic Encephalopathy, Humans, Liver Cirrhosis, Male, Middle Aged, Prospective Studies, Psychological Tests, Severity of Illness Index, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Logistic Models, Case-Control Studies, Interleukin-18, Young Adult
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