Bacterial DNA translocation contributes to systemic inflammation and to minor changes in the clinical outcome of liver transplantation

Abstract

Bacterial (bact)DNA is an immunogenic product that frequently translocates into the blood in cirrhosis. We evaluated bactDNA clearance in patients undergoing liver transplantation (LT) and its association with inflammation and clinically relevant complications. We prospectively included patients consecutively admitted for LT in a one-year follow-up study. We evaluated bactDNA before and during the first month after LT, quantifying cytokine response at 30 days. One hundred patients were included. BactDNA was present in the blood of twenty-six patients undergoing LT. Twenty-four of these showed bactDNA in the portal vein, matching peripheral blood-identified bactDNA in 18 cases. Thirty-four patients showed bactDNA in blood during the first month after LT. Median TNF-α and IL-6 levels one month after LT were significantly increased in patients with versus without bactDNA. Serum TNF-α at baseline was an independent risk factor for bactDNA translocation during the first month after LT in the multivariate analysis (Odds ratio (OR) 1.14 [1.04 to 1.29], P = 0.015). One-year readmission was independently associated with the presence of bactDNA during the first month after LT (Hazard ratio (HR) 2.75 [1.39 to 5.45], P = 0.004). The presence of bactDNA in the blood of LT recipients was not shown to have any impact on complications such as death, graft rejection, bacterial or CMV infections. The rate of bactDNA translocation persists during the first month after LT and contributes to sustained inflammation. This is associated with an increased rate of readmissions in the one-year clinical outcome after LT.

The Prognostic Value of the Detection of Microbial Translocation in the Blood of Colorectal Cancer Patients

“…To this end, various research groups have attempted to develop PCR-based methods for the detection of microbial fragments in the blood of patients undergoing surgeries, with chronic myalgias, liver transplantations, Crohn's diseases, etc. [10,11,[34][35][36]. However, to our knowledge, little progress has been made, and small cohorts have been enrolled in the detection of microbial translocation in the blood of cancer patients.…”

“…In the current study, we aimed to use a PCR-based method for the detection of microbial (bacterial and/or fungal) DNA in the blood of patients with adjuvant or metastatic CRC. In a previous study, Rodriguez-Laiz et al evaluated the gut bacterial DNA translocation in the blood of 100 patients undergoing liver transplantation [35]. Bacterial DNA was detected in the blood of 26% and 34% of patients undergoing liver transplantation and after one month, respectively.…”

“…Bacterial DNA was detected in the blood of 26% and 34% of patients undergoing liver transplantation and after one month, respectively. Interestingly, such translocation contributed to systemic inflammation, but no impact on clinical outcome was reported [35]. In another study, the authors analyzed blood samples from 40 surgical patients for the detection of 16S rRNA, β-galactosidase of E. coli, and glutamine synthase of B. fragilis [11].…”

Characterization of the circulating microbiome in acute‐on‐chronic liver failure associated with hepatitis B

“…This implies that the equilibrium between bacteria and host was impaired in HB‐ACLF patients, which may represent an increased microbial burden, altered microbial composition and aberrant bacteria‐host interaction. Unlike the large number of studies on the intestinal microbiome, research on the circulating microbiome is in its infancy . The aim of this study was to qualitatively and quantitatively assess the alteration of circulating microbial communities and their functions, as well as their associations with SI and clinical outcome in HB‐ACLF patients.…”

Systemic and Extraradicular Bacterial Translocation in Apical Periodontitis

“…atheroma plaques, arthritic joints) ( Reichert et al., 2013 ; Chhibber-Goel et al., 2016 ; Berthelot and Wendling, 2020 ). It has been proposed that periodontal bacteria can be transported to distant tissues internalized in immune cells in arthritis ( Martinez-Martinez et al., 2009 ; Ibrahiem et al., 2011 ), involving mononuclear cell activation, production of pro-inflammatory cytokines, and risk for future NCD complications ( Sahingur et al., 2010 ; Rodriguez-Laiz et al., 2019 ). Up to now, reports of extraradicular endodontic infection are limited, whereas further bacterial outreach to blood remains unknown.…”