Large intestine permeability is increased in patients with compensated liver cirrhosis

Pijls, Kirsten; Koek, Ger H.; Elamin, Elhaseen; Vries, Herman de; Masclee, Ad; Jonkers, Daisy

doi:10.1152/ajpgi.00330.2013

Cited by 42 publications

(38 citation statements)

References 39 publications

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“…The functional integrity of the epithelial barrier is maintained by intercellular tight junctions (TJs), which include the transmembrane protein occludin, claudins and the cytoplasmic protein zonula occludens 1 (ZO-1) (6). Intercellular TJ protein destruction is associated with a number of diseases, including cirrhosis (7). Therefore, restoring the integrity of the intestinal barrier is an important step in preventing intestinal endotoxemia.…”

Section: Introductionmentioning

confidence: 99%

Bletilla�striata polysaccharide has a protective effect on intestinal epithelial barrier disruption in TAA‑induced cirrhotic rats

et al. 2018

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It has been reported that intestinal epithelial barrier dysfunction serves an important role in the development of liver cirrhosis. However, at present there is no satisfactory treatment for intestinal mucosal lesions and ulcers associated with cirrhosis. The aim of the present study was to investigate the effect of Bletilla striata polysaccharide (BSP) on intestinal epithelial barrier disruption in rats with thioacetamide (TAA)-induced liver cirrhosis. Rats were randomly divided into 5 groups (n=10): BSP low dosage (15 mg/kg), BSP middle dosage (30 mg/kg), BSP high dosage (60 mg/kg), experiment and control groups. All groups except control group were administered with TAA (200 mg/kg/day) to induce liver cirrhosis. Following modeling, rats in the low, middle and high-dose BSP groups received BSP. ELISA kits were used to measure the endotoxin, alanine transaminase (ALT) and aspartate transaminase (AST) levels in the portal vein, while interleukin (IL)-6 and tumor necrosis factor (TNF)-α expression in the ileal tissue was measured. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting were used to detect the expression of zonula occludens (ZO)-1 and occludin mRNA and protein, respectively. Intestinal epithelial tissue pathology was detected using hematoxylin-eosin (HE) staining. Immunohistochemistry was performed to assess the expression of ZO-1 and occludin in intestinal epithelial tissues. Following treatment with BSP, ALT, AST and endotoxin levels in the portal vein, as well as IL-6 and TNF-α expression in ileal tissues, were significantly decreased compared with model group (P<0.05 or 0.01). Furthermore, BSP treatment upregulated the expression of ZO-1 and occludin mRNA and protein compared with the model group (P<0.05 or 0.01) and cytoplasmic staining for these proteins was increased. The degree of intestinal epithelial tissue pathological damage was significantly reduced in the BSP groups. In conclusion, BSP is able to reduce endotoxin levels, inhibit the inflammatory cytokines IL-6 and TNF-α and elevate expression of ZO-1 and occludin at tight junctions. Together, these results suggest a novel protective agent for the restoration of intestinal epithelial barrier disruption.

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Section: Introductionmentioning

confidence: 99%

Bletilla�striata polysaccharide has a protective effect on intestinal epithelial barrier disruption in TAA‑induced cirrhotic rats

et al. 2018

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“…Sandek et al [15] reported morphological and functional alterations of the gut in CHF patients, with an increased permeability index in both the small and large intestine. Pijls et al [35] reported an increased colonic permeability in patients with compensated liver cirrhosis. In patients with burn injuries, in patients undergoing cardiopulmonary bypass surgery and in critically ill patients who developed multi-organ failure, intestinal permeability was shown to be increased [36-40].…”

Section: Discussionmentioning

confidence: 99%

Increased Small Intestinal Permeability during Severe Acute Exacerbations of COPD

et al. 2018

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Background: Disturbances of intestinal integrity, manifested by increased gastro-intestinal (GI) permeability, have been found in chronic obstructive pulmonary disease (COPD) patients during physical activity, often associated with intermittent hypoxic periods. Evidence about extrapulmonary organ disturbances, especially of the GI tract, during hospitalised acute exacerbation of COPD (AE-COPD) with hypoxaemic respiratory failure (RF) is lacking. Objective: The aim was to assess changes in GI permeability in patients with AE-COPD and during recovery 4 weeks later. Methods: All patients admitted to our hospital with AE-COPD accompanied by hypoxaemia at admission (PaO₂ <8.7 kPa or O₂ saturation <93%) were screened between October 2013 and February 2014. Patients with a history of GI or renal disease, chronic heart failure, or use of non-steroidal anti-inflammatory drugs in the 48 h before the test were excluded. GI permeability was assessed by evaluating urinary excretion ratios of the orally ingested sugars lactulose/L-rhamnose (L/R ratio), sucrose/L-rhamnose (Su/R ratio) and sucralose/erythritol (S/E ratio). Results: Seventeen patients with severe to very severe COPD completed the study. L/R ratio (×10³) at admission of AE-COPD was significantly higher than in the recovery condition (40.9 [29.4–49.6] vs. 27.3 [19.5–47.7], p = 0.039), indicating increased small intestinal permeability. There were no significant differences in the individual sugar levels in urine nor in the 0- to 5-h urinary S/E and Su/R ratios between the 2 visits. Conclusion: This is the first study showing increased GI permeability during hospitalised AE-COPD accompanied by hypoxaemic RF. Therefore, GI integrity in COPD patients is an attractive target for future research and for the development of interventions to alleviate the consequences of AE-COPD.

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“…Studies using sugar as a differential marker in absorption tests, combining an oligosaccharide and a monosaccharide, such as in lactulose/mannitol (L/M) and saccharose/mannitol, revealed increased intestinal permeability in patients with liver cirrhosis 6,15,57–59,85–96…”

Section: Analytic Methods To Determine Intestinal Permeabilitymentioning

confidence: 99%

“…In patients with liver cirrhosis, alterations in intestinal permeability correlate with the degree of liver injury whereby Child–Pugh C patients and those with ascites or a positive history of SBP have increased intestinal permeability to the passage of molecules58 although patients with compensated cirrhosis have been shown to have increased colonic permeability but not gastroduodenal or intestinal 59. However, other authors have been unable to reproduce these results 60…”

Section: Intestinal Permeability In the Patient With Liver Cirrhosismentioning

confidence: 99%

Intestinal permeability in a patient with liver cirrhosis

Valadez

Rivera-Espinosa

Méndez-Guerrero

et al. 2016

TCRM

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Liver cirrhosis is a worldwide public health problem, and patients with this disease are at high risk of developing complications, bacterial translocation from the intestinal lumen to the mesenteric nodes, and systemic circulation, resulting in the development of severe complications related to high mortality rate. The intestinal barrier is a structure with a physical and biochemical activity to maintain balance between the external environment, including bacteria and their products, and the internal environment. Patients with liver cirrhosis develop a series of alterations in different components of the intestinal barrier directly associated with the severity of liver disease that finally increased intestinal permeability. A “leaky gut” is an effect produced by damaged intestinal barrier; alterations in the function of tight junction proteins are related to bacterial translocation and their products. Instead, increasing serum proinflammatory cytokines and hemodynamics modification, which results in the appearance of complications of liver cirrhosis such as hepatic encephalopathy, variceal hemorrhage, bacterial spontaneous peritonitis, and hepatorenal syndrome. The intestinal microbiota plays a fundamental role in maintaining the proper function of the intestinal barrier; bacterial overgrowth and dysbiosis are two phenomena often present in people with liver cirrhosis favoring bacterial translocation. Increased intestinal permeability has an important role in the genesis of these complications, and treating it could be the base for prevention and partial treatment of these complications.

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Large intestine permeability is increased in patients with compensated liver cirrhosis

Cited by 42 publications

References 39 publications

Bletilla�striata polysaccharide has a protective effect on intestinal epithelial barrier disruption in TAA‑induced cirrhotic rats

Bletilla�striata polysaccharide has a protective effect on intestinal epithelial barrier disruption in TAA‑induced cirrhotic rats

Increased Small Intestinal Permeability during Severe Acute Exacerbations of COPD

Intestinal permeability in a patient with liver cirrhosis

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