Changes of intestinal wall barrier function and its correlation with susceptibility to infection in patients with cirrhotic portal hypertension.
10.3760/cma.j.cn501113-20220118-00031
- Author:
Xiao Yu LIN
1
;
Chen LI
1
;
Ting ZHANG
1
;
Jing CHEN
1
;
Jia Ji JIANG
1
;
Qi ZHENG
1
Author Information
1. Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatology and Intestinal Diseases, Fuzhou 350005, China.
- Publication Type:Journal Article
- Keywords:
Clinically significant portal hypertension;
Infection;
Intestinal permeability;
Liver cirrhosis;
Macrophages
- MeSH:
Humans;
Nitric Oxide Synthase Type II;
Lipopolysaccharide Receptors;
Prospective Studies;
Biomarkers;
C-Reactive Protein/analysis*;
Liver Cirrhosis/complications*;
Hypertension, Portal
- From:
Chinese Journal of Hepatology
2023;31(1):70-76
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the changes of intestinal wall barrier function and its correlation with infection occurrence in patients with cirrhotic portal hypertension. Methods: 263 patients with cirrhotic portal hypertension were split into: the clinically evident portal hypertension (CEPH) combined with infection group (n = 74); CEPH group (n = 104); and Non-CEPH group (n = 85). Among them, 20 CEPH patients and 12 non-CEPH patients in non-infection status were subjected to sigmoidoscopy. Immunohistochemical staining was used to detect the expression of trigger receptor-1 (TREM-1), CD68, CD14, the inducible nitric oxide synthase molecule, and Escherichia coli (E.coli) in the medullary cells of the colon mucosa. An enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1), soluble leukocyte differentiation antigen-14 subtype (sCD14-ST) and intestinal wall permeability index enteric fatty acid binding protein (I-FABP). Fisher's exact probability method, one-way ANOVA, Kruskal-Wallis-H test, Bonferroni method, and Spearman correlation analysis were used for statistical analysis. Results: The serum sTREM-1 and I-FABP levels were higher in CEPH patients than those of non-CEPH patients in the non-infectious state (P < 0.05), but the difference in blood sCD14-ST levels was not statistically significant (P > 0.05). Serum levels of sTREM-1, sCD14-ST, and I-FABP in infected patients were higher than those in patients without a concurrent infection (P < 0.05). Serum sCD14-ST levels were positively correlated with serum sTREM-1, C-reactive protein (CRP), and procalcitonin (PCT), and sTREM-1 levels were also positively correlated with CRP and PCT (r > 0.5, P < 0.001). The rates of CD68, inducible nitric oxide synthase, CD14-positive cells, and E.coli-positive glands were higher in the intestinal mucosa of the CEPH group than those of the control group (P < 0.05). Spearman's correlation analysis showed that the rate of E.coli-positive glands in CEPH patients was positively correlated with the expression of molecular markers CD68 and CD14 in the lamina propria macrophages. Conclusion: Patients with cirrhotic portal hypertension have increased intestinal permeability and inflammatory cells, accompanied by bacterial translocation. Serum sCD14-ST and sTREM-1 can be used as indicators to predict and evaluate the occurrence of infection in patients with cirrhotic portal hypertension.
